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SUMMER 2002 





Founding editor Joseph 
Garland '19 served two terms 
at the Harvard Medical Alumni 
Bulletin: from 1 927 to 1 929 
and from 1 967 to 1 971 . A 
long-time editor of the New 
England Journal of Medicine, 
Garland helped to give the 
journal an international pres- 
ence. His successor there, 
Franz Ingelfinger '36, called 
him "the master of whimsical 

SI MMER 2002 • XiMl'ME 76, NUMBER 1 


Letters 3 

Pulse 5 

The Angina Monologues, U.S. News & 
World Report rankings, a Talking Heads 
exhibit, Match Day results 

President's Report 1 1 

by Paul]. Dans 

Bookmark 12 

A review by Elissa Ely of This Side of 
Doctoring: Reflections from Women in Medicine 

Bookshelf 13 

Benchmarks 14 

Care for a splash of milk in your tea? 

Class Notes 66 

InMemoriam 69 

Neil Samuel Ghiso 

Obituaries 70 

On Doctoring 72 

Medical notations from the past 



75 Years of Doctoring Text 16 

The Bulletin celebrates its diamond jubilee by revisiting the wit and 
wisdom of generations of Harvard physicians. 

Learning Curves 18 

Historical and social forces have influenced the way medicine has been 
taught at HMS for the past 75 years, tv beveelv b a l l a r o 

Witnesses to the Revolution 28 

Harvard alumni reflect on the births of modern medicine and surgery. 

•BRIGHTNESS HAS FALLEN by ogles by paul 
• INCISIVE MOMENTS by george dunlop 

Like Shakespeare and the Bible 36 

The Bulletin's readers have been dispensing editorial advice for the 
past 75 years, b pauia b y r o n 

The Art Is Long 46 

In past pages of the Bulletin, physicians have reflected on defining 
moments in their relationships with patients. 

And Now a Word from Our Sponsors 54 

For 75 years, Bulletin advertisers have peddled remedies for America's 
woes, from diaper rash to despondency 

Skeletons in the Closet 60 

Test your knowledge of HMS lore, play "Connect the Docs," and discover 
what some little black numbers reveal about the School's history. 

Cover photography bx Stephen Webster 

Harvard Medical 


In This Issue 


I half its present age. Unbeknownst to me, I was the last student 
I to be admitted that year (something I would learn later when 
I comparing dates with a classmate who had it on good authority 
that she was the second-to-last). We clung to each other a bit after that, but 
contrary to our dire first-year expectation that failure and disgrace were 
imminent, we both managed to graduate. I did so despite the fact that as a 
first-year student I was stumped by the trick anatomical question alluded 
to in the quiz that begins on page 60 of this issue — and, indeed, had trouble 
identifying many of the structures that seemed of considerable interest to 
the anatomy faculty. My classmate went on to a distinguished academic and 
administrative career. By an odder twist of fate, I have become the steward of 
this increasingly venerable publication, now for one-tenth of its existence. 

It has been a singularly happy task, perhaps in large part because the growth 
curve of the Bulletin has so been much flatter than that of the medical school 
as a whole. Unlike the great majority of medical school publications, we are 
small, surprisingly independent, and not directly linked to a development 
office. Which is not to say that we resist development in any way, but only that 
the character of the Bulletin continues to be shaped as much by the needs and 
interests of our alumni as by the imperatives of institutional growth. 

Although we have emboldened the format of the Bulletin in the past few years, 
to stay within our budget we still print our contents two colors short of the full 
deck. I find the effect, on the whole, trustworthy and serene — nrinimizing what 
Rorschach interpreters call "color shock." We employ a staff that is too small to 
produce all the copy required even for our four issues a year. Instead, we rely on 
a large cadre of unpaid writers — the graduates of Harvard Medical School. Our 
readers may be unaware that this is a distinctive feature of the Bulletin, a publica- 
tion that is as much of and by the people who read it as for them. What we lack 
in profiles of high-flying faculty and heavy-duty research initiatives we trust is 
more than offset in our pages by the diverse voices of the remarkable women 
and men who have been shaped by the School. And it is our hope that, as we 
provide a forum for graduates to talk with each other and the institution, we 
help them in turn to shape the institution and its values. 

It is possible that in years to come electronic formats will supplant certain 
functions of this modest publication, now 75 years on paper. My hunch is 
that they will at best only supplement the printed, bound, and posted object, 
which I hope will continue in a form not much different from what it is now. 
There is a need for pages that cannot be scrolled; for type that is laid once on 
the surface and stays there, defining a rectangle of common ground; and for 
the renewal that comes from a succession of issues, steadily clocking the 
myriad changes, both subtle and drastic, that have made 1927 come to seem 
like such a remote place in time. 



William Ira Bennett '68 


Paula Brewer Byron 


Beverly Ballaro, PhD 


Susan Cassidy 


Elissa Ely '88 


Judy Ann Bigby '78 
Rafael Campo '92 

Elissa Ely '88 

Atul Gawande '94 

Robert \1. Goldwyn '56 

Perri Klass '86 

Victoria McEvoy 75 

James J. O'Connell '82 

Nancy E. Oriol 79 

J. Gordon Scannell '40 

Eleanor Shore '55 

John D. Stoeckle '47 


Laura McFadden 


Paul J. Davis '63, president 
Mitchell T. Rabkin '55, president-elect 1 
Eve J. Higginbotham 79, president-elect 2 

Paula A. Johnson '85, vice president 

Maria C. .Alexander- Bridges '80, secretary 

Cecil H. Coggins "58, treasurer 


Rafael Campo '92 

Barbara J. McNeil '66 

Gina T. Moreno-John '94 

DeWayne M. Pursley '82 

Laurence J. Ronan '87 

Mark L. Rosenberg 72 

Nanette Kass YVenger '54 

Francis C. Wood, Jr. '54 

Kathryn A. Zufall-Larson 75 


Daniel D. Federman '53 


Nora N. Nercessian, PhD 


Joseph K. Hurd '64 

&M,\ 1/aA 

The Harvard Medical .Alumni Bulletin is 

published quarterly at 25 Shattuck Street, 

Boston, MA 02115 '' by the Harvard 

Medical Alumni Association. 

Phone: (617) 384-8900 . Fax: (617) 384-8901 

Email: bulletm^hms. 

Third class postage paid at Boston. 

Massachusetts. Postmaster, send form 3579 

to 25 Shattuck Street, Boston. MA 02115 

ISSN 0191 7757 • Printed m the U.S.A. 






'Don't be like the people of my 
generation who sit there and 
complain about how managed 
care is destroying medicine but 
don't do anything about it." 


Into the Fray 

In the Autumn 2001 issue, Benjamin 
Carson, empowered by the moral 
authority of his remarkable personal 
story, chides those who "complain about 
how managed care is destroying medi 
cine but don't do anything about it, leav- 
ing the decision making in the hands of 
businesspeople, who are also responsible 
for earnings per share." Dr. Carson could 
have gone further and given that Class 
Day audience a view of the problem ter- 
rain and a road map to the solution. 

Patients hate the double digit premium 
hikes, the bureaucratic hassles, and the 
loss of free choice of doctor and hospital 
that HMOs represent. Doctors resent the 
nonprofessional second-guessing and the 
undermining of the doctor/ patient rela- 
tionship. Worst of all, and not mentioned 
by Dr. Carson, is the accelerating disaster 
of the uninsured, fueled by growing 
unemployment and the soaring premiums 
and drug prices that are forcing hard 
pressed employers to reduce health cover- 
age or even drop it altogether. 

Thus, we careen toward what colum 
nist David Broder predicts will be "a per- 
fect storm" in health care. As I approach 
my 50th reunion, I have been contem 
plating the great paradox of American 
medicine. Alone among the modern 
countries, we consider health care a 
commodity and do not accept a societal 
obligation to cover everyone. The World 

Health Organization ranked our system 
37th in the world. Yet we can provide the 
best medical care on the planet, and not 
just at great centers — such as HMS and 
Dr. Carson's Johns Hopkins — where 
astonishing advances in care have 
emerged in the last half century. 

Specifically, what should the outstand 
ing clinicians, researchers, teachers, and 
administrators at our great centers — not 
to mention the rest of us — do? We should 
urge our representatives in Congress to 
join the Congressional Universal Health 
Care Task Force and work toward pas 
sage of House Concurrent Resolution 99. 
This resolution would direct Congress 
to enact legislation by October 2004 that 
provides access to comprehensive health 
care for all Americans. Although it does 
not endorse any one model of reform, the 
resolution lists 14 key attributes of a just 
and efficient health care system. 

Let's get off the bench and join 
Dr. Carson in the arena. 


By My Troth 

I am writing to acclaim the excellent Ten- 
sion of the Hippocratic oath by the Class 
of 2001 and the literate and concise eluci 
dation of the renewed covenant by Jeffrey 
Munson. Granting that idealism in the 

setting of a commencement has its haz- 
ards, I felt that Dr. Munson's restatement 
of the mission of the medical profession 
was extraordinarily well expressed. 

I doubt whether, at our commence- 
ment 65 years ago, even those who later 
proved to be among the most literate and 
articulate of our class — Lewis Thomas 
and Russ Elkinton — even in that era of 
Dr. Francis Peabody's "Care of the 
Patient," could have expressed medical 
and professional aspirations as strongly 
and clearly as did Dr. Munson and his 


March Madness 

I couldn't help but smile at the letter to 
the editor that James Davis '47 wrote in 
the winter edition of the Bulletin. I 
entered the Navy in 1945 as a Hospital 
Corpsman after three semesters at Har- 
vard, but was just a senior at the Boston 
Latin School when Dr. Davis was a 
freshman soldier at HMS. 

Some of your readers might not know 
that Boston Latin is down the street 
from Vanderbilt Hall, just beyond the 
old Boston Lying-in Hospital. In those 
days the Boston public schools had a 
School Boy Cadet Corps starting in the 
ninth grade. Latin was a large high 
school, and we had two regiments of 
cadets. After four years, we got pretty 
good at marching and manipulating our 
old Springfield rifles. By the time we 
were seniors, we were usually officers, 
and I ended up commanding a company 
of ninth graders. 

One day, I was sitting in a study hall, 
and the teacher had left the room. Some 
one yelled, "Come look at this!" Everyone 
rushed to the windows. There, marching 
down Avenue Louis Pasteur, was a ragtag 
bunch, all in the fuzzy khaki dress uni- 
form of the U.S. Army. We thought of 
ourselves as connoisseurs, and, as kids 
will do, had some wise remarks to make. 
Someone proclaimed that these guys 
were HMS students. I was particularly 




interested in this small parade, because I I gwg Thing FneiTIV 

hoped to attend that school someday and 

become a doctor. I was not impressed, 
and remember hoping that HMS made 
better doctors than it did soldiers. 

Years later I asked a somewhat older 
HMS grad what it had been like to be a 
medical student and in the Army at the 
same time. He explained that the stu- 
dents had all been gathered in the Van- 
derbilt Hall gymnasium, where they were 

Reading my classmate Albert England's 
letter in the Winter 2002 issue, in which 
he kindly recalled an open-heart surgery 
I performed on an injured soldier during 
World War II, brought back many mem- 
ories. I'd like to share one in particular. 

In December 1944, elements of the 
60th Division of the Third Army were 
desperately fighting — and dying — in the 

After four years, we got pretty 
good at marching and manipu- 
lating our old Springfield rifles. 
By the time we were seniors, 
we were usually officers. 


told that they could either join the Army 
and stay in school, or be drafted at once 
into the infantry. The response was no 
surprise: everyone volunteered. On the 
first day, after the swearing-in process 
had concluded, the "troops" were massed. 
An officer, perhaps Major Rosengard, 
delivered an oration, which ended with 
this motivating exclamation: "Okay, men, 
now let's make this a real medical school!" 
Parenthetically, in 1947 when I 
returned to Harvard College from the 
Navy, they were trying to get all the vet 
erans out as fast as possible. They want- 
ed to give me a year of credit for my 
training and experience, but I managed 
to graduate as a member of the Class of 
1948 in 1949. I do not regret my service, 
which was a defining experience in my 
life. As for my four years at "the Medical 
School," I was glad 1 did not have to 
learn to march there. 


litde town of Saarlautern, Germany. My 
team had pulled up to give them surgical 
support. We set up a makeshift medical 
station in a red brick schoolhouse on a 
riverbank in a nearby town and began 
receiving a steady flow of casualties, 
whom I triaged as they were being 
unloaded from an ambulance. One of the 
medics came and said, "Doc, Pve got a 
couple of wildcats for you. These two 
guys shot each other from across the 
street, then were swatting at each other 
in the ambulance until the morphine 
cooled them down. Keep your eye on 'em." 
The Yank, whom I'll call "Bruce," had a 
nasty slanting wound in his belly that 
had cut a furrow, exposing a couple of 
perforated and protruding loops of small 
bowel. We covered them with moist 
abdominal pads, then explored the entire 
abdominal cavity. When we found no 
other internal injuries, we irrigated the 
cavity and repaired the two injured 
intestinal segments. 

When we had debrided the damage to 
the abdominal wall, controlled the bleed- 
ing, and inserted the drains, we realized 
that closure was going to be difficult. But 
we had run out of stay sutures. So I asked 
a corpsman to remove the laces from the 
new pair of boots I was wearing and soak 
them in bichloride of mercury solution 
while I operated. After we had prepped 
the wound and before we closed it in the 
various abdominal layers, we inserted six 
or seven of the eight- inch rawhide strips 
through little parallel stab wounds on 
each side of the incision. We then tied the 
thongs across the incision snugly but not 
too tightly, or they would hamper circu 
lation and cause sloughing and infection. 

We then began the repairs on the 
German lad, whom I'll call "Gunther." His 
wound was an upward slanting perfora 
tion through the right chest. The cut had 
caused little damage beyond his profuse 
bleeding, which we were able to control. 
We persuaded one of our helper German 
prisoners to donate a liter of matching 
blood to his countryman. This pulled 
Gunther out of incipient shock. Then we 
dealt surgically with his wound. 

In our wards for the next four days, 
Bruce and Gunther both recovered well. 
The first day, they only glared at each 
other. The second day, Bruce offered Gun- 
ther a stick of gum. That broke the ice, 
and they began trying out each other's 
language. The next day they were talking 
like old friends in a broken mixture of 
English and German. They were laughing 
together and showing each other family 
pictures and even their wounds. The final 
day, they insisted on being sent to follow- 
up treatment units in the same ambu 
lance and to the same hospital unit. 

These two boys who, a few days before, 
had tried to kill each other at the insis- 
tence of their commanders, could have 
been brothers — even in appearance. Does 
this incident say something about war? 


Editor's note: We were saddened to learn that 
Dr. Stone died on April 28, shortly after we 
received his letter 




The Angina Monologues 


Show marked the 100th 
anniversary of the Aes- 
culapian Club, which 
sponsors the student- 
produced spectacle. To 
commemorate the occa- 
sion, the Class of 2004 
invited audience mem 
bers to consider what 
might have happened if (gasp!) HMS had 
never existed. 

The play opens with a disgruntled 
student wishing away her life at medical 
school. She is visited by three spirits 
who usher in a world where HMS is no 
more, leaving its professors to find new 
careers. As Act One, "The Angina Mono 
logues," begins, Daniel Lowenstein '83, 
dean for medical education, embarks on 
a career as a dancer; lecturer Cynthia 
McDermott becomes a kindergarten 
teacher; and neurology professor Elio 
Raviola goes into business. 

Act One concludes with a turf war. 
West Side Story-style, between the 
"Teeth" (students from the dental 
school, of course) and the 
"Geeks" (students from 
Health Sciences and Technol- 
ogy). While the Teeth pro- 
claim, "I want to work on 
cavities/I want to charge 
outrageous fees," the /& 
Geeks sing, "I'll 
explain stereochem 
istry/To undergrad 
geeks who worship 
me." Clearly, with 
out their studies to 

oddly clad spirit of 
HMS helps usher in 
visions of life without 
medical school, where 
students and teachers 
are forced to sing for 
their supper. 

IT'S A WONDERFUL LIFE: A cast of wacky characters teach the value of medical school. 
Above, students impersonate Professors Elio Raviola (left) and Dan Goodenough. 

keep them busy, the students are get- 
ting out of hand. 

The chaos continues in Act Two, "Viva 
Las Vagus," with a Pulp Fiction spoof cen- 
tered on the neurology department. And 
as the show follows the misadventures of 
other HMS professors, the cast regu 
arly breaks into song-and-dance 
routines, including Latin num- 
bers ranging from traditional 
salsa to contemporary pop. 
Without medicine to fall 
back on, several male pro- 
fessors become exotic 
dancers, and if that's not 
enough to satisfy the audience, 
Lowenstein returns for a final 
disco number (to the tune of 
ABBA's "Dancing Queen": "See 
that guy/Watch that dean/His 
name is Lowenstein"). 

By the show's finale, how 
ever, the disgrunded student 
has realized that life at HMS 

isn't so bad after all. To the tune of "There's 
No Business Like Show Business" from 
Annie Get Your Gun, the cast of the Second 
Year Show belts out, "There's no business 
like our business like no business I 
know/Everything inside you starts to 
shake up/When your paper in Nature 
appears/In no other field do they pay 
you/To look inside other people's ears." On 
that note, second years return to their 
studies, and the audience leaves with new 
insight into the life of the medical student. 
Chris Boulton, who co produced 
the show with Lori Coburn, Loretta 
Erhunmwunsee, and Sabrina Vineberg, 
says she gained new admiration for her 
fellow students. "The Second Year Show 
really opened my eyes to the phenomenal 
group of people who make up my class," 
she says. "I walked away from the expert 
ence with a profound appreciation for the 
uniquely talented, intelligent, and caring 
group of people that I feel privileged to 
call my classmates." ■ 




Lucky 1 3 

When U.S. News & World Report released its 2003 ranking of medical 
schools, HMS was cited as the country's top medical school in research for 
the 13th year in a row. The School placed seventh among medical schools in 
primary care. Among the medical specialties, HMS ranked first for inter- 
nal medicine, pediatrics, and women's health. The School captured the 
number two spot in both geriatrics and drug and alcohol abuse, and 
ranked third in AIDS. Harvard also ranked second for graduate programs 
in biological sciences. In the science specialties, Harvard came in first for 
molecular biology, microbiology, biochemistry, and cell biology (tying 
with Stanford). In neuroscience, Harvard placed second. 

Tenley Albright '61 
with her father, 
Hoi lis Albright '31, 
in 1956 

The Future of Neurosciences 

The Second Annual Hollis L. Albright '31 Symposium will explore "The Future of 
Neurosciences at HMS" on October 1 7. Speakers will include Steven Hyman '80, provost 
of Harvard University; Carla Shatz, chair of the HMS Department of Neurobiology; and 
Joseph Martin, dean of HMS. The Hollis L. Albright '31 Award will be presented during 
the symposium. (Registration will begin at 4:00 p.m. in the Tosteson Medical Education 
Center at 260 Longwood Avenue in Boston; continuing medical education credit is available 

For more information, contact Tenley Albright '61 at 617-247-8202 or Tenley 1 


DEBITS AND CREDITS: At a Scholarship 
Recognition Luncheon, Dean Joseph 
Martin (left) talks with Alvan Ikoku '03. 

On Borrowed Time 


your early 30s, working in a sub- 
specialty not known for especially 
high rates of compensation. You are 
married and would like to start a 
family, but there is one detail hold- 
ing you back: as a result of pursuing 
a career path you love, you owe 
your medical school S50,000 and 
the federal government an addition- 
al $100,000. This is not a fictional 
scenario, but one recent HMS grad- 
uate's real-life predicament. 

The prospect of making monthly 
loan repayments totaling nearly 
52,000 for many years to come has 
led this graduate and his wife to put 
their plans to have children on 
indefinite hold, as they struggle to 
figure out how to refinance their 
debt burden in a way that will allow 
them to maintain their modest 
lifestyle and, at the same time, plan 
responsibly for child care, insurance, 
college, and other family costs. 

"I love what I do," says this gradu 
ate, who prefers to remain anony- 
mous. "But frankly, if I had to choose 
all over again, knowing what I do 
now and having to deal with the 
psychological stress that comes 
with carrying such a large debt bur- 
den, I carft say with certainty that I 
would take the same path." 

What has HMS administrators 
worried is that this graduate's debt 
dilemma — and his reaction to it — is 
not at all unusual. To help alleviate 
the burden, this spring. Dean Joseph 
Martin announced the HMS Schol 
arship Campaign, whose goal is to 
raise S35 million over the next three 


years. The new funds will directly 
benefit students by reducing the 
amount of money in loans needed to 
attend HMS and replacing it with 
increased grant support. 

Seventy percent of HMS students 
receive financial assistance. For 
members of the Class of 2002, the 
average educational debt upon grad 
uation was more than $88,000, with 
many owing more than §150,000. 
Currently, only 6 percent of endowed 
funds are earmarked for scholarships. 

Martin characterized the enor- 
mous debts accumulated by many 
students as "a staggering load for 
someone about to indenture him- or 
herself to three to eight years of res 
ident training. Already the impact of 
student debt is making itself felt in 
choosing a specialty." Noting that 
today's young doctors are entering a 
"vastly altered medical world," Mar 
tin pointed out the career limita 
tions imposed by "managed care, 
uncertain salaries, and weakened 
hospitals and practice groups." 

In conversation after conversation 
with recent graduates, Daniel Feder- 
man '53, senior dean for alumni rela- 
tions and clinical teaching, has heard 
confirmation of this disturbing ten- 
dency for some students to "turn 
away from career choices that they 
deeply want and are uniquely suited 
for" in response to the burden of 
debt. "We seek for the School to 
reflect the future of America — and 
for that matter, the world," Feder 
man said, adding that "at the same 
time we are also deeply committed 
to the middle-class students whose 
families just can't carry the entire 
burden of a medical education." 

Thus far, more than $18 million 
has been raised during the "quiet 
phase" of the campaign. "By lowering 
student debt," Martin said, "scholar 
ships allow graduates the increased 
freedom to follow the career path 
that they most desire, be it in acade- 
mic medicine, primary care, or ser- 
vice in underprivileged areas." 

Talking Heads 


l % mm personality and patterns of behavior? Today we use 
k 'A 'i I psychology and genetics to wrestle with these eternal ques- 
tions; the nineteenth century found its own explanations in 
phrenology — the study of human cranial structures and their implications 
for human nature and character. More than just reading bumps on the 
head, phrenology had a complex theoretical framework and a long evolu 
tion. The movement elicited great interest among scientists and the public 
in the United States and Europe. The Countway Library of Medicine 
recently mounted an exhibit, "Talking Heads," to explore the basis for 
phrenological study, some of the major figures associated with it, and the 
unique role that Boston played in the history of this popular movement. 

Highlights of the exhibit include texts and medals of Franz Joseph Gall 
the founder of phrenology, and manuscripts, books, 
a silhouette, and an oil painting of J. G. Spurzheim, 
Gall's assistant, who visited Boston in 1832 to 
promote the new science. In the mid-nineteenth 
century, Orson and Lorenzo Fowler turned phrenol- 
ogy into a wildly profitable business, seeking to 
improve the lot of humankind through teaching, lec- 
turing, and interpreting the contours of heads. Sam- 
ples of the Fowlers' character readings, symbolic 
heads, and popular phrenology manual are dis- 
played in the Countway exhibit, along with some of 
the satiric prints inspired by the movement. Publica- 
tions, advertisements, and historical records of the 
British Phrenological Society — which remained 
active until 1967 — testify to the enduring fascina- 
tion of this peculiar study of skulls. 

"Talking Heads" will 

be on display at 

the Countway 

library of Medicine 


October 4, 2002. 

To learn more, contact 

Jack Eckert at 


or jack_eckert@hms. For the 

online gallery, visit 

talking heads. 





country on March 21 — Match Day — in finding out where they would be spending their res- 
idency. Ninety- seven percent of this year's graduating class opted to pursue clinical pro- 
grams. About half will remain in Massachusetts, with nearly 96 percent of those at HMS 
affiliated hospitals. Other frequently chosen locations for residencies were California (19 
percent) and New York (13 percent). The most popular specialties were internal medicine 
(30 percent); pediatrics (10 percent); radiology (8 percent); and general surgery (8 percent). 


Angeline Chong 

Johns Hopkins Hospital 

Kurt Fink 

Brigham and Women's Hospital 

Susan Wittman 

University of Massachusetts 
Medical School 


Rita Fisler 

University of Kansas School 
of Medicine 

Matthew Halpern 

St. Luke's-Roosevelt Hospital 
Center, New York, NY 

Scott Smith 

Duke University Medical Center 


Mark Bisanzo 

Brigham and Women's Hospital 

Jonathan Kenyon 

Harbor-UCLA Medical Center 

Tamara Rubin 

Johns Hopkins Hospital 


Ellen Chen 

University of California, 
San Francisco 

Laura Gottlieb 

University of Washington 
Affiliated Hospitals, Seattle 

Stephen Martin 

Boston University Medical 

Tara Scott 

Sutter Medical Center, 
Santa Rosa, CA 

Debra Stulberg 

West Suburban Hospital, 
River Forest, IL 


Frank Acosta 

University of California, 
San Francisco 

Kristofer Charlton-Ouw 

New York Presbyterian Hospital 

Emily Christison-lagay 

Massachusetts General Hospital 

Ravi Ghanta 

Brigham and Women's Hospital 

Dawn Hostreiter 
Mayo Graduate School 
of Medicine, Rochester, MN 

David Kuwayama 

Johns Hopkins Hospital 

Xiaodong Li 

Beth Israel Deaconess 
Medical Center 

Anthony McCluney 

Massachusetts General Hospital 

Robert Oakes 

Stanford University Programs 

Hannah Piper 

University of British Columbia, 


Francisco Rubio 

Beth Israel Deaconess 
Medical Center 

Richard Urman 

Beth Israel Deaconess 
Medical Center 

Jason Williams 

Johns Hopkins Hospital 


Vincent Aguirre 

Brigham and Women's Hospital 

David Andorsky 

Brigham and Women's Hospital 

Elizabeth Austen 

Massachusetts General Hospital 

David Barbie 

Massachusetts General Hospital 

Hacho Bohossian 

Beth Israel Deaconess 
Medical Center 

Janelle Brown 

University of Washington 
Affiliated Hospitals, Seattle 

Suzanne Brown 

Brigham and Women's Hospital 

Sanders Chae 

New York Presbyterian Hospital 

Yi-Bin Chen 

Massachusetts General Hospital 

Zev Frankel 

Johns Hopkins/Sinai 


Kate Grossman 

New York Presbyterian 
Hospital (Columbia] 

Anurag Gupta 

Brigham and Women's Hospital 

Mary Hu 

Stanford University Programs 

Sohah Iqbal 

New York Presbyterian 
Hospital (Columbia) 

Ugonna Iroku 

New York Presbyterian 
Hospital (Cornell] 

Jason Koontz 

Duke University Medical Center 

Kapil Kumar 

New York Presbyterian 
Hospital (Columbia) 

Joyce Liu 

Brigham and Women's Hospital 

Duy Nguyen 

Massachusetts General Hospital 

Eyiuche Okeke 

New York Presbyterian 
Hospital (Columbia) 

Warren Phipps 

University of California, 
San Francisco 

Christina Rail 

University of California, 
San Francisco 

Ravi Ranjan 

Massachusetts General Hospital 

Cairiin Reed 

University of California, 
San Francisco 

Rajat Rohatgi 

Stanford University Programs 

Calie Santana 

Brigham and Women's Hospital 

Pasha Sarraf 

Massachusetts General Hospital 

Adam Shaywitz 

Massachusetts General Hospital 

Ma Somsouk 

Harbor-UCLA Medical Center 

Lynn Sosa 

Massachusetts General Hospital 

Elizabeth Speliotes 

Massachusetts General Hospital 

Emily Tsai 

Hospital of the University 
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Mount Sinai Hospital 
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Massachusetts General Hospital 

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New York Presbyterian 
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UCLA Medical Center 


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Brigham and Women's Hospital 

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New York Presbyterian 

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Harvard/Brigham and 
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University of North 
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New York Presbyterian 
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University of Washington 
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University Health Center 
of Pittsburgh 


Christine Shortsleeve Ament 

Massachusetts Eye 
and Ear Infirmary 

Kevin Cranmer 

Wills Eye Hospital, Philadelphia 

Jasmine Hayes 

University of Southern California 

Carolyn Kloek 

Massachusetts Eye 
and Ear Infirmary 

Brandon Lujan 

University of California, 
San Francisco 


Lawrence Juvet 

Massachusetts General Hospital 


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during Alumni Week, under 
the tent on the Quadrangle, I 
turned the Alumni Associa 
tion gavel over to Mitchell Rahkin '55. I 
know that many in the audience were 
thinking at the time about the root 
derivation of gavel (from gafol, a tax or 
tribute, e.g., capital gains gafol, as Saxon 
legislators were wont to use the term 1 ). 
The chilled multitude rendered unto 
Mitch a gajoi to indicate that they were 
pleased with the prospects for the com- 
ing year. And so they ought to be — Mitch 
and the Alumni Council have an impor 
tant agenda for 2002-2003. 

First, the analysis of the recendy con 
eluded alumni survey wall be completed 

graduate schools, industry, and minority 
based professional organizations — for 
insights and strategies. The initiative also 
takes an important look at faculty recruit 
ment within the affiliated hospitals. 

Third, the Council will conduct a 
survey to determine how HMS gradu 
ates estimate the value of their career 
choices in a medical world in which ref 
ere nee points are rapidly shifting. 

Finally, a new program that Mitch 
suggested has already begun. It puts 
freshly minted HMS graduates in con- 
tact with HMS alumni already in the 
house staff training programs that the 
new graduates are about to enter. 

When you receive your local school 
gafol bill this fall, you w ill likely think of 

Your responses to the questions — particularly, 
"What would you discuss with Dean Joseph 
Martin if you had 20 minutes with him?" — 
will, I think, make extraordinary reading. 

this fall. We will report the results on the 
.Alumni Associations web site and in the 
Bulletin. The demographic information we 
received from the thousands of you who 
responded is helpful, and your responses 
to the questions — particularly, "What 
would you discuss with Dean Joseph Mar 
tin if you had 20 minutes with him?" — 
will, I think, make extraordinary reading 
for you, as they have for Dean Martin, 
Daniel Federman '53, Nora Nercessian, 
and those of us on the Council. (This 
archive is now 600 pages of single-spaced 
typescript. When we ask the question 
next year, we'll limit your answers to just 
three minutes with the dean.) 

Second, this project will create a tern 
plate that will improve the School's abili 
ty to recruit underrepresented minority 
faculty. Encouraged by the dean, this 
effort by Mitch and other Council mem 
bers has tapped a number of regional and 
local resources — including other Harvard 

Mitch and the Alumni Council and its 
agenda — and it's good that you will. 2 
The Alumni Council at HMS works. It's 
mission oriented, it's accessible to you, 
it has vitality, it collaborates creatively 
with the dean, and it benefits hugely 
from the insights of Dan Federman and 
Nora Nercessian. ■ 

Paul J. Davis '63 is senior associate dean for 
clinical research at Album \ ledical College. 

^Thc German term for gavel, der Hammer, 
doesn't quite convey the same message. Or does it- 

2 Saint Bedc tells us that the concept of an annual 
school tax originated in Northumbria. The 
Bedc also notes that it was Portia of Middle 
Anglia who wrote, "Pride goeth before a gafol." 
Portia conceived the special purpose entity 
(SPE) that permitted Anglo Saxon business- 
people to keep huge debts off their balance 
sheets. She traded in firewood futures. 


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This Side of Doctoring 

Reflections from Women in Medicine 

edited by Eliza Lo Chin '93 (Sage Publications, 2002) 

"Can a woman physician 
be lovable?" 



where she was the only woman in her department. She wore 
gingham and checks, went by her first name, and blushed at 
the blackboard. Hopes for a humane summer rose in the 
hearts of 200 premed students who, to a person, lacked an 
atom of interest in organic chemistry. 

That July Prince Charles married Diana in Westminster 
Abbey. At the end of a lecture on stereoisomers, someone 
suggested that Penny might want to let us go early in honor 
of her countrywoman. The professor turned from the 
board. "I find Diana nothing to celebrate," she said. "I have 
no time for that nonsense." Her chalk squeaked. 

I happened to be in her office later that morning, desper- 
ate for a fix on stereoisomers. It was as if a pipe welded in 
Britain had burst in America. All through the help ses- 
sion, she gushed bitterly from behind her 
desk about what it had taken to become 
the only woman chemist at Oxford — a 
training far more punishing and isolating 
than any Diana would know. A dog's life 
had more support. I left full of despair about 
left and right-handed molecules but full of 
relief on a different matter. Thank God, I 
thought, I'm only going to be a doctor. 

Not that the accomplishments of women 
physicians are insignificant. The most astound- 
ing part of This Side of Doctoring: Reflections from 
Women in Medicine, edited by Eliza Lo Chin '93, 
comes just after its end, with the 35 pages of 
contributor bios. Never mind managing a med- 
ical career and a family — there are dual degrees 
and multiple fellowships. One surgeon has pub 
lished more than 100 articles and book chapters. Another skis 
and does underwater photography. This professor of family 
medicine carves rocks. That one speaks in schools about colo- 
nial medicine. This pediatrician has four children, that 
endocrinologist has five, this psychiatrist six, and the 
nephrologist only two — but she raises chickens as well. 
There are also pioneer doctors from the early nineteenth cen- 
tury; one married at 14, and most made house calls by horse. 

Here, these authors write of themselves in forthcoming, 
naked, and strangely unprofessional ways; none of these 
pieces would feel at home in a medical chart. There are chap- 
ters with titles like "Barriers," "Connections," and "Balanc- 
ing," and entries called "From Chivalry and Off Color Jokes to 
Acceptance and Respect," "Whine List," "Where Is the Self?" 
and "mommydoc." I am sure my professor's patience for the 
entire project would be limited. I can see her in the lab, that 
consummate and devastated chemist, wearing protective eye- 
gear while she skims and then tosses the book away. She Has 
No Time For That Nonsense. 

Still, barriers and balancing are our lives. Any doctor- 
mother struggles with and against her own biological 
instincts: caring for a febrile patient in the ICU when her 
own babv is at home with a higher fever; after a night on -call, 
being tucked into bed by her toddler, when it should have 
been the other way around. The experience of bearing and 
mothering children is exclusively female, and doctoring 
drains time from the precious project. "Raising children," 
writes one specialist (as only a specialist could), "is likc.the 
natural history of diabetic neuropathy... You know the prog- 
nosis, but you do whatever it takes to slow it down." 

Deciding not to mother or bear children is also a woman's 
choice alone. Two especially moving pieces, from women 
who chose childlessness, may be the bravest and 
most poignant writing in the book. They 
paid honestly and painfully for fully med- 
ical lives, when it is once again culturally 
incorrect — after a few decades of toler- 
ance — to be childless. 

In order to relax with this kind of book, 
though, you must decide not to argue one 
of its assumptions: that women corner the 
market on emotional experience. All physi- 
cians are changed forever by the labors 
of training, professional ambivalence, and 
loss of personal time and meaning. Waves 
of tenderness toward patients followed by 
guilty dispassion rise in both sexes. Men, 
too, weep after giving terrible news to 
hoping families. HMOs enrage everyone. 
Women hold no patents here. 
Penny could not have tolerated This Side of Doctoring. 
It covers the same territory over and over again: job, child, 
mate, compression, depression, complaint, reward. Yet life 
itself — for those of us who survived premedical educa 
tion — is juggling the balls of work, love, and motherhood 
over and over again. It takes years of practice to make it 
look easy and it is impossibly acrobatic, but all the fuss is 
because these are the only balls that matter. ■ 

Elissa Ely '88 is a lecturer on psychiatry at HMS. 










When Every Moment Counts 

\\ hat You Need to Know about 
Bioterrorism from the Senate's Only Doctor 
by Senator Bill Frist 78 
(Rowman & Littlefield Publishers, 2002) 

Senator Frist offers practical advice to 
help readers protect themselves in today's 
uncertain times. He includes information 
on biological agents such as anthrax and 
smallpox, the dangers posed by chemical 
weapons, and the vulnerabilities of our 
food and water supplies. The book also 
includes a list of Web sites to help readers 
keep up with changes as they develop. 

The Symbolic Impetus 

How Creative Fantasy Motivates Development 
by Charles T. Stew art '50 
(Free Association Books, 2001) 

The author, a Jungian child psychiatrist, 
offers his perspective on the role of the 
symbolic process in the maturation of 
personality and in the therapeutic over- 
coming of blocks to growth. The book 
describes the phases of the symbolic 
process as well as healing roles played by 
the symbolic modes characteristic of 
different stages of development. 


A Surgeons Notes on an Imperfect Science 
by Atul Gawande '94 
(Metropolitan Books. 2002) 

explores the conflicts and uncertainties 
that lie at the heart of modern medicine. 
Dramatic stories detail the treatment of 
patients with such challenging cases as 
necrotizing fasciitis, morbid obesity, and 
chronic pain. Other essays address ethical 
issues, including the failure of physicians 
and organizations to police the profession. 

The Healthy Kitchen 

Recipes for a Better Body, Life, and Spirit 
by Andrew Weil '68 and Rosie Daley 

(Knopf 2002) 

Weil and co-author Rosie Daley team up 
to present an easy-to-use guide to prepar 
ing meals that are not only health)', hut 
also attractive and tasty. In addition to 
more than a hundred recipes, the book 
features calorie and nutrition break 
downs, shopping guides, and tips on 
involving children in meal preparation. 
Weil reviews his philosophy of nutrition 
in his introeluction and sprinkles more of 
his advice throughout the book. 

Aging Well 

Surprising Gmdcposts to a Happier 
Life from the Landmark Harvard Study 
of Adult Development 
by George E. Vaillant '59 
(Little, Brown and Company, 2002) 

In his debut essay collection, surgeon 
and New Yorker staff writer Gawande 

Combining hard data from the Study of 
Adult Development at Harvard Universi- 
ty with individual case histories, Vaillant 
offers an explanation of why some peo- 
ple live more healthily and happily than 
others. The book shows how individual 

lifestyle choices play a greater role than 
genetics, wealth, or race in determining 
the quality of people's later years. 

A Mind at a Time 

America's Top Learning Expert Shows 
How Every Child Can Succeed 
by Mel Lcvinc '66 
(Simon & Schuster, 2002) 

Drawing on research into brain function 
as well as his own 30 years of working 
with students from kindergarten through 
12th grade, Levine shows how children 
learn in unique ways based on the 
strengths of their neurodevelopmental 
systems. The book provides a guide to 
help parents and teachers detect early 
signs of breakdowns in learning and rec- 
ognize each child's untapped assets. 

At the Front Lines of Medicine 

How the Health Care System Alienates 
Doctors and Mistreats Patients.. .and 
What We Can Do About h 
by Howard Waitzkin 72 
(Rowman & Littlefield Publishers, 2001) 

The author analyzes how costs, coverage, 
and access to medical care have changed 
the way doctors make decisions about 
patient care. He discusses why a commu 
nity's social and economic conditions 
have more impact on health outcomes 
than the type or quality of available health 
services, and describes a plan of action for 
improving health care in the United 
States. The book also vividly illustrates 
the dilemmas that patients often face. 





For Heart Attack Victims, A Little Tea with That Sympathy 


basis may help protect 
patients with existing car 
diovascular disease, accord 
ing to a study in the May 7 issue of 
Circulation, which found an association 
between tea consumption and an 
increased rate of survival following a 
heart attack. 

"The health benefits of tea have 
been reported in numerous studies in 
recent years, but among healthy indi 
viduals the evidence of tea's benefits is 
actually mixed," notes the study's lead 
author, Kenneth Mukamal, an HMS 
assistant professor of medicine in the 
Division of General Medicine and Pri- 
mary Care at Beth Israel Deaconess 
Medical Center. "The greatest benefits 
of tea consumption have been found 
among patients who already have car- 
diovascular disease." 

Mukamal and his co-authors found 
that among people who had suffered 
heart attacks, those who reported 
being heavy tea drinkers had a 44 per- 
cent lower death rate than non-tea 
drinkers in the three and a half years 
following their heart attacks, while 
moderate tea drinkers had a 28 percent 
lower rate of dying when compared 
with the non-tea drinkers. 

The key to this protection appears 
to lie with a group of antioxidants 
known as flavonoids, which are plenti- 
ful in both black and green tea. 
Flavonoids, which are also found in 
certain fruits and vegetables, could be 
working to help the heart in one of 
several ways, according to Mukamal. 

"It's pretty clear that flavonoids 
can prevent LDL [low-density lipo- 
protein] cholesterol from becoming 
oxidized," he says, explaining that 
oxidized LDL can lead to the develop- 
ment of atherosclerosis. In addition, 
a recent study found that drinking 
black tea improved endothelial func 
tion — the ability of the blood vessels 
to relax — in cardiac patients. Finally, 


Mukamal adds, flavonoids may have 
an anti- clotting effect. 

The observational study was made 
up of 1,900 men and women, mainly in 
their 60s, who were interviewed an 
average of four days after suffering a 

heart attack and asked to report how 
much caffeinated tea they typically 
drank each week. The participants 
were then separated into three groups: 
non-tea drinkers, moderate tea 
drinkers (fewer than 14 cups per week). 

and heavy tea drinkers (14 or more 
cups per week). 

On the basis of these criteria, 1,019 
participants were categorized as 
non-tea drinkers, 615 were moderate 
tea drinkers, and 266 were heavy tea 
drinkers. The participants were fol 
lowed up 3.8 years later, at which 
time 313 of them had died, most of 
them from cardiovascular disease. 
After accounting for differences in 
age, gender, clinical factors, and life 
style factors, the researchers found an 
inverse relationship between tea con- 
sumption and mortality. 

"What was surprising was the 
magnitude of the association," Muka 
mal says. "The heaviest tea drinkers 
had a significantly lower mortality 
rate than the non-tea drinkers." 

As is the case with any observa- 
tional study, he notes, these findings 
could be accounted for by differences 
in lifestyle other than tea drinking. 
"One of the biggest potential criti 
cisms of this study is that people who 
drink tea might be expected to live 
healthier lifestyles than people who 
don't drink tea," Mukamal explains. 

"But among this particular group — 
people mainly in their 60s who had 
suffered heart attacks — tea con 
sumption was not strongly related to 
lifestyle," Mukamal adds. In other 
words, the participants were similar 
in terms of education, income, exer- 
cise habits, and smoking and drink 
ing habits whether they drank a lot of 
tea or no tea at all. 

Mukamal does caution, however, 
that although these findings strong 
ly suggest that tea consumption 
reduces the risk of death following 
a heart attack, controlled clinical 
studies still need to be conducted. In 
the meantime, a nice cup of hot tea 
may just hit the spot. ■ 

Bonnie Prtscott is a science writer at Beth 
Israel Deaconess Medical Center. 

Got Milk? Good. 



could give those milk-mus- 
tached celebrities in televi- 
sion and magazine ads a 
new reason to proclaim the benefits 
of dairy foods. In a study of 3,000 
young adults, Mark Pereira, David 
Ludwig, and their colleagues found 
that subjects who consumed the 
greatest amounts of dairy products 
had a lower risk of developing 
insulin resistance syndrome, a pre- 
cursor to heart disease and dia- 
betes. The effect was most marked 
in overweight subjects who, by 
virtue of their extra poundage, are 
already most vulnerable to the syn- 
drome and its sequelae. 

"Insulin resistance syndrome is 
the soil in which two main killers of 
Americans grow — type 2 diabetes 
and heart disease," says Ludwig, 
HMS assistant professor of pediatrics 
at Children's Hospital and senior 
author of the study in the April 24 
issue of the Journal of the American 
Medical Association. Pereira, also an 
HMS assistant professor of pediatrics 
at Children's Hospital, is lead author. 

Insulin resistance syndrome — a 
combination of obesity, hypertension, 
abnormal glucose metabolism, and 
dyslipidemia (low levels of high-densi- 
ty lipoprotein cholesterol in serum) — is 
on the rise among young Americans. 
At the same time, young people are 
consuming less milk and more soft 

drinks, fewer dairy products and 
more refined carbohydrates. 

To explore the relationship between 
insulin resistance syndrome and dairy 
consumption, the researchers ana- 
lyzed the intake of dairy products by 
young adults enrolled in the Coronary 
Artery Risk Development in Young 
Adults (CARDIA) study. Among over- 
weight subjects, those consuming the 
smallest amount of dairy were at least 
three times more likely to develop 
insulin resistance syndrome after ten 
years than those eating the most. The 
effect was less evident in lean sub- 
jects, who may be protected against 
obesity and insulin resistance for 
genetic or other reasons. 

How do those glasses of milk and 
cheese wedges confer their benefit? 
One possibility is that dairy products 
contain a health-promoting factor. 
Yet when the researchers accounted 
for factors found in dairy, such as 
calcium, the correlation with reduced 
risk of insulin resistance remained 
unchanged. Another possibility is that 
dairy drinks and foods are more sati- 
ating than equivalent numbers of 
calories in refined carbohydrates. Pre- 
vious work by Ludwig, director of the 
obesity program at Children's Hospi- 
tal, and colleagues has shown that 
refined starchy foods and concen- 
trated sugars, which have a high 
glycemic index, promote hunger and 
food intake among obese teenagers. 

More research is needed before 
dietary recommendations about 
dairy can be made, Ludwig says. 
Based on his and other researchers' 
work, he believes that current nutri- 
tional recommendations promoting 
low-fat, high-carbohydrate diets may 
need reevaluating. "When people 
are focusing on cutting back on fat, 
they are not eating more fruits and 
vegetables," he says. "They are con- 
suming bagels, fat-free Twinkies, and 
soda pop." ■ 

Misia Landau is senior science writer 
for Focus. 



inaugural year, when Elliott Cutler '13 
tartly characterized the difference 
between surgery and medicine in these 
terms: "Mistakes in surgery may cost 
the patient his life, whereas a little more 
or less rhubarb or jalap hardly does more 
than hasten the step." For 75 years, 
Harvard Medical School graduates 
have reflected on medicine's shifting 
landscape. Trading stethoscopes and 
scalpels for pens and now keyboards, 
they have recorded in the Bulletin's pages 
their hopes and homilies for medicine, 
as well as their fears and frustrations. 


Schmidt and nurse Florice 
Smith attend to a young 
patient at the House of the 
Good Samaritan in 1937. 


vu ^Oe^e^^ ^&&&aw> 

Historical and social forces have 
influenced the way medicine 
has been taught at Harvard Medica 
School for the past 75 years 


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"WE ARE IN THE MIDST ofanother 

war and facing the prospect of a diminishing supply of 
acceptable male students. Without doubt the question 
of accepting women students will arise again." 

the world would embark on an odyssey 
of military and social upheaval that 
would profoundly alter life at HMS and 
in the nation at large. 

Inevitably such seismic shifts in the 
culture revolutionized both the sub- 
stance and philosophy of education at 
HMS. In 1927, Elliott Cutler '13 noted in 
the Bulletin: "Education, like clothing, is 
somewhat a matter of fashion and runs 
in cycles, now long, now short, now 
bedecked with much show and many 
frills, again reduced to almost naked 
simplicity" The decades that followed 
revealed the perspicacity of Cutler's 
observation. Over the past 75 years the 
Bulletin has chronicled the many ways in 
which HMS has reflected — and some- 
times resisted — the social and historical 
forces that have shaped the educational 
environment of the School and the 
methods used to train its graduates. 



that had long anchored instruction 
at HMS was undergoing a significant 
transformation. Memorization had tra- 
ditionally served as the foundation of an 
HMS education; a 1929 Bulletin article 
described how students on hospital 
wards were required to 

memorize and regurgitate their patients' 
histories and test results so as to gain a 
basis of clinical experience that, supple- 
mented by reading, would eventually 
become "that practical, working knowl- 
edge of medicine that enables the physi- 
cian to become a good diagnostician and 
a wise therapeutist." 

Yet inside HMS classrooms, a new 
approach was taking hold. The period 
leading up to the 1930s had witnessed 
the institution of a new exam system 
after a review committee's analysis had 
revealed the inadequacy of most of the 
memory tests to which the students had 
previously been subjected. The faculty 
had adopted a fresh approach to evaluat- 
ing students, as a Bulletin progress report 
on the School made clear: "Correlation 
became the keynote. Since then, such 
broad questions as 'Discuss milk,' 'Dis- 
cuss jaundice,' or 'Discuss the functions 
of the blood' aim to test the student's 
ability to arrange his knowledge in an 
orderly fashion and to correlate normal 
structure and function with the causes, 
mechanisms, and symptoms of disease." 

This trend toward a less didactic, 
more practical approach to medical edu- 
cation accelerated in the 1930s. By 1932, 
HMS students were taking voluntary 
anatomy courses in which they created 
their own plasticine models of brains. By 
1935, they were attending controversial 

new lectures on human sexuality and 
birth control, topics about which "in the 
past it had been felt by the authorities 
that it was best to give instruction as 
unobtrusively as possible." Students 
who voiced religious objections to the 
subject matter were excused. 

By the middle of the decade, so perva- 
sive was the air of change about HMS that 
one alumnus felt compelled to reassure 
grumbling fellow graduates that, not- 
withstanding rumors to the contrary, 
research had not eclipsed the School's tra- 
ditional primary mission: "An idea seems 
to prevail among certain alumni, who have 
not visited the teaching clinics for years, 
that students there are taught by full-time 
men a whole lot of research 'bolony' and 
but little of the care of the patient. A \isit 
would prove that this is not so." 



the character of life at HMS, even as the 
administration strove to maintain a 
sense of normalcy on campus. Wartime 
conditions led to acute difficulty in 
obtaining instructors, so a number of 
retired faculty members returned to 
the School's classrooms to help ease the 


crisis. But one dean worried about the 
dangers of a reduced national doctor 
force functioning "with considerably less 
than a third of its normal complement of 
young men who are able to do emergency 
work, to attend to night calls without 
undue fatigue, and to carry out the most 
recent technical procedures, which old 
hands find so difficult to master." 

The war effort also raised unsettling 
questions about admissions. World 
War I had produced a shortage of suit- 
able male candidates, leading to a 1917 
scheme to award Radcliffe degrees to 
women trained at HMS; this idea, 
Reginald Fitz '09 noted, had quickly 
"exploded rather like a toy balloon." Yet, 
he warned, in 1943 "we are in the midst 
of another war and facing the prospect of 
a diminishing supply of acceptable male 
students. Without doubt the question of 
accepting women students will arise 
again." The next year the president and 
fellows of Harvard College voted to 

allow women to be admitted to HMS, a 
decision the Bulletin characterized as 
"drastic and precedent shattering " 

Meanwhile, the war was transforming 
the ways in which medicine was being 
taught and researched in HMS class- 
rooms and laboratories. A 1941 Bulletin 
article analyzed the impact of Pearl Har 
bor on the national psyche and boldly 
predicted that World War II would 
advance the young field of psychiatry in 
the same way that World War I had led 
to major breakthroughs in surgery: "No 
longer will psychiatry be viewed as a 
luxurious specialty." 

Sometimes the knowledge gained 
from civilian disasters on the home front 
translated serendipitously into military 
application. When a fierce fire at the 
Cocoanut Grove, a popular Boston night 
club, claimed nearly 500 lives in 1942, the 
School immediately released many stu- 
dents to work at area hospitals. 

"One cannot estimate yet what good 
may come out of this terrible 
accident," the Bulletin 
reported, "but 

FIRST LADIES: The dozen 
women who entered HMS 
in 1945 shattered a gender 
barrier that had lasted more 
than a century and a half. 

great interest was aroused in Boston in 
the discussion of methods of treatment 
of burns. Opportunity was given for 
important research both in this line and 
in the effect of noxious gases." 

Yet most of the medical breakthroughs 
generated during the war resulted from 
secret studies carried out by HMS faculty 
under contract with the federal Office of 
Scientific Research and Development. In a 
1946 article entitled "Now It Can Be Told," 
the Bulletin touted the accomplishments of 
HMS investigators exploring such topics 
as: "the mode of action of mustard gas in 
the eye"; "the effect on military personnel 
of chronic exposure to loud sounds"; 
"the relation of electroenccphalographic 
patterns to personality characteristics in 
candidates for flying training"; and "the 
development of artificial limbs superior 
to those in current use." 



reflected the anxiety, pride, and mourn- 
fulness of a nation at war, the 1950s 
were replete with nostalgia for the pre- 
war past and robust optimism about the 
future. After World War II, according to 
the Bulletin recollection of Sidney Farber 
'27, the School's departments received 
"soft money from the federal govern 
ment in huge amounts, far beyond their 
wildest imagination." 



HMS graduates have 

played pioneering roles in 

medicine and surgery for 

more than three centuries. 

In 1 954, Joseph Murray '43B 

performed the world's first 

human kidney transplant 

(pictured here). 

One Bulletin contributor lamented the 
primacy that research seemed to have 
wrested from clinical activities: "It is 
trite to repeat at this date that research 
won the war. The impact of all this flood 
of money and abrupt change of direction 
has been tremendous. Our medical 
schools and hospitals have gone over- 
board for Research. It is the magic name, 
the 'Open Sesame,' to success in 1954." 

The content of the HMS curriculum 
underwent substantial revisions in 
response to the advances in medical 
knowledge that wartime research had 
spurred. At the same time, the School 
was coming to grips with changes in 
America's social landscape. World War II 
had led to the greater integration and 
visibility of women in American society. 
By mid-decade, one of the first women 
to enter HMS reported in the Bulletin 
that "women graduates of Harvard are 
doing well in their respective fields. 
Those of us who are now in school feel 
that we are gradually becoming inte- 
grated and that the tendency is to 
accept our presence as routine." By 1958, 
a letter to the Bulletins editor noted that 
the announcement that female students 
would soon be permitted to live in Van- 
derbilt Hall was greeted "in general 
with a shrug of the shoulders." 

The presence of women altered the 
culture of the School in ways large 

and small. The 1950s witnessed the 
passing of the 

annual First-Year, Fourth-Year Riot, a 
long- standing tradition "directly related 
to the Aesculapian Club Show, and indi- 
rectly related to springtime, the end of 
senior exams, high blood-alcohol levels, 
and, some say, chronically blocked hor- 
mone utilization." By the decade's end, 
the Bulletin reported, the vandalism pre- 
viously tolerated as "boys will be boys" 
hijinks had reached a point where a 
crackdown became necessary: "The Aes- 
culapian Club Show was cleaned of its 
more objectionable jokes. There was no 
riot. Women attended." 



gradually gave way to ever- increasing 
displays of rancor and discord as HMS in 
the 1960s reflected a society sharply 
divided over issues of civil rights, 
drugs, and, above ^^k 

all, the war in Vietnam. The spirit of con- 
tentiousness spilled over into discus- 
sions of changes to the HMS curriculum. 
A heated debate flared over whether a 
research focus was inappropriately dis- 
placing a curriculum centered on patient 
care. Responding to the chorus of those 
who believed that "such emphasis on sci- 
ence will destroy the humanitarian prin- 
ciples of medicine," one alumnus defend- 
ed the symbiotic relationship of bench 
and bedside, writing in the Bulletin that 
"sympathy cannot overcome ignorance 
any more than science can wipe away the 
grief of a bereaved parent." 

But the allure of science exerted an 
ever stronger pull on the imaginations of 
many inside the School. A 1962 Bulletin 
article described the demand for new and 
better ways of managing 


"IT IS TRITE TO R E P E AT at this date 

that research won the war. Our medical schools and hospitals 
have gone overboard for Research. It is the magic name, the 
'Open Sesame,' to success in 1954." 

the enormous, constantly evolving mass 
of medical knowledge. Noting the ixrita 
tion often displayed by members of the 
HMS community inquiring whether it 
was true that the new Countway 
Library of Medicine was to be equipped 
with the usual periodical racks and 
bookshelves rather than computers, the 
article observed, "The frustrations that 
arise out of the literature explosion seem 
to generate in the minds of some indi 
viduals an impatience with libraries for 
not providing automatic machines to 
store scientific information and to 
retrieve on demand unspecified, but 
presumably tailor made answers. For a 
while yet. the Countway will be a library 
of books and journals, but who knows 
what manner of push button library 
may someday deliver within its walls 
undreamed of information services?" 

Despite the enthusiasm over gains 
made by science and technology in this 
era, inside HMS classrooms, some stu- 
dents worried that a crucial humanitari- 
an component was missing. One member 
of the Class of 1967 summarized the "vast 
disappointment" oi many of his peers in 
harsh terms: "The portraits of those stern 
and determined Harvard greats had 
promised a legacy that was beginning to 

look about as substantive as oil on can- 
vas. Most of our lectures seemed to be 
lacking in basic moral fiber, let alone 
towering moral stature." 

The School's administrators conceded 
that reforms were in order. As early as 
L962, HMS Dean George Berry wrote of 
the need to create "greater learning 
opportunities, a greater chance to ask 
questions, and a greater freedom to pur 
sue them." Defending these changes. 
Berry explained "Basically, we are deal 
ing with the difference between educa- 
tion and training. The best synonym for 
education is growth. Training, on the 
other hand, is something that one can do 
to seals, to dogs, and — alas! — to medical 
students. Training is the acquisition of 
factual knowledge and techniques. As 
these increase, training demands ency 
clopedic memorization, a requirement 
that can blot out education." 

For the first time in the School's his 
tory, students took curriculum reform 
directly upon themselves. In 1965, about 
two dozen second year students pro- 
posed an educational experiment, 
accepted by the dean and faculty, that 
involved replacing lectures with guided 
readings, independent studies, small 
group discussions, and streamlined lab 
oratory work. To foster habits of inde 

pendent thinking and scholarship, a 
faculty committee eventually recom- 
mended reducing the amount of factual 
memorization pressed on students by 
introducing a coordinated interdepart 
mental core curriculum. 

HMS admissions profiles also were 
changing in the turbulent 1960s in 
response to the civil rights movement. 
Within three days of the assassination 
ol Martin Luther King, jr., two junior 
faculty members and one student began 
organizing colleagues to discuss ways 
to increase educational and job oppor 
tunities for minorities. When an ad hoc 
committee proposed setting aside 15 
places for black students, some faculty 
objected to what they regarded as a 
quota. In the end, the School estab- 
lished 15 scholarships for "disadvan 
taged" students and, to appease critics, 
at the same time increased class size 
from 125 to 140, so there would be no 
reduction in the number of spots avail 
able for "traditional" applicants. 

Affirmative action was only one oi 
many controversies that sharply divided 
the HMS community during the 1960s. 
Yet no issue proved so polarizing to the 
educational environment of the School, as 
it did in the nation at large, as the Ameri- 
can military intervention in Indochina. 
From 1966 on, the Bulletin contained 



"THE PHOTOGRAPH ofDeanEbertand 

others participating in a peace demonstration in downtown 
Boston is the most disgusting, disturbing, and disappointing event 
that has ever been depicted in the Bulletin. " 

numerous exchanges in letters to the edi- 
tor that grew increasingly acrimonious 
as the conflict — and opinions on cam- 
pus — continued to heat up. 



including the World War II era, the 
1970s witnessed a direct and powerful 
connection between the Zeitgeist of the 
outside world and changes taking place 
in the HMS curriculum and classrooms. 
Alumni, faculty, and students began 
taking on more activist roles in what 
many of them viewed as a struggle for 
social justice. The dialogue on civil 
rights in the nation at large turned 
inward, as the School focused increas- 
ingly on issues of minority student 
admissions and status at HMS. And a 
generation gap evident in responses to 
the Vietnam War emerged in ever 
harsher relief, as older alumni and 
recent graduates angrily clashed in their 
assessments of what — and whom — 
HMS should represent. 

A 1970 Bulletin photo spread on HMS 
peace demonstrations, including a shot 
of Dean Robert Ebert carrying an anti- 
war protest sign in downtown Boston, 
triggered an 

avalanche of responses from alumni. 
One 1923 graduate railed that the 
photograph represented "the most dis- 
gusting, disturbing, and disappointing 
event that has ever been depicted in the 
Bulletin. Is it any wonder that immature 
students protest, violate the law, and 
participate in campus riots with such 
an example set for them by the Dean?" 

Other, equally furious letters, both 
of attack and support, poured in. One 
older alumnus complained, "I think 
many of us have perhaps felt somewhat 
resentful of the tacit assumption by 
some of our younger colleagues that we 
are all in favor of killing, that we char- 
acteristically deliver poor medical care, 
and that we are unconcerned." 

At one graduation ceremony of the 
era, a peace banner hung suspended 
behind the platform as the class presi- 
dent read a statement expressing "con- 
cern over the current American politi- 
cal, social, and environmental crises." A 
1932 graduate wrote in response: "I am 
sure that I would not have been able to 
endure the stench of the oral flatus 
being emitted on the platform." 

Another alumnus characterized the 
speaker as a "highly excitable young- 
ster" and asked, "Is it true that HMS 
officials have allowed students to orga- 
nize a strike committee and, if so, how 

does it happen that they have time to 
attend meetings of such lawless crimi- 
nals as the Black Panthers and other so- 
called dissident groups who do not 
choose to obey the laws of our country?" 

The clash of attitudes between alumni 
and students took on an even more 
scathing tone as the decade wore on. The 
Bulletin published one alumnus's recollec- 
tion of providing medical care to young 
people at Woodstock. That event, he 
predicted, would likely be remembered 
as "a huge pleasant nothing" attended by 
a crowd whose legacy, thanks to its "irre- 
sponsible, 'free-loader' attitude," was "an 
immense mountain of papers, bottles, 
cans, clothing, excreta, and every con- 
ceivable type of refuse that, as usual, 
mama or papa would clean up or pay 
somebody else to do." 

That writer's disillusionment was 
shared by some other alumni, one of 
whom declared: "I am appalled by pre- 
sent Harvard students who appear on 
the wards with filthy, disreputable 
clothes, dirty fingernails and hands, and 
hairy bodies, purporting to be physi 
cians. Most patients cringe and I per- 
sonally wouldn't let them touch me 
with a ten-foot pole. Their unspeakable 
hygiene is only outdone by their degrad- 
ing conduct and morals." 



A follow up pica Irom a 1979 gradu 
ate asked: "Recent Bulletin lettcts by some 
alumni about Harvard medical students 
have been unfair and highly intolerant. 
Current residents of Yanderbilt Hall, for 
example, have been likened to infec 
tious agents. Isn't it time to end the acri- 
mony of the late 1960s and set aside 
divisive rhetoric?" 

Yet the divide did not heal. The disen- 
chantment experienced by many HMS 
students of the 1970s frequently translat 
ed into angry expression at graduation 
and, just as often, outraged backlashes 
against the speakers found their way into 
print in the Bulletin. 

The 1974 commencement featured a 
talk entitled "The Unmaking of a Doctor," 
in which the speaker condemned aspects 
of the education he had received "One of 
the best things I learned at Harvard is 
that common things occur commonly, 
but, unfortunately. Harvard does not 

teach common things. We are the best 
trained physicians in the world to treat 
cholera — knowledge useless here in the 
USA. But do we know much about alco- 
holism, drug addiction, depression, or 
sexual dysfunctions? We all learned the 
theoretical importance of the fava bean, 
but what about the epidemiology of 
tuberculosis in the Boston ghettoes, the 
unique medical concerns of gay people, or 
all the intricacies of obtaining abortions? 

"I am angry," the speaker went on to 
conclude, "that Harvard, complacent 
behind its mystique, made learning to 
become a doctor such an unnecessarily 
bard task, while having the audacity to 
claim that it was making us leaders of 
medicine. A friend of mine was reflect 
ing on one rotation in medicine but his 
phrase applies equally to all four years: 
'Let us not forget how truly bad it was.'" 

A 1934 graduate expressed his distaste 

tor the contents of two speeches of 

the era in a letter in which he 

asked whether one of the 

^_ speakers and 

Robert Ebert's participation 
in a downtown Boston anti- 
war demonstration sparked 
controversy among alumni 
during the Vietnam era. 

her classmates "expect that the Alma 
Mater (like the multi-breasted Hindu 
goddess of fertility) would have a special 
teat, gushing psychotherapeutic milk for 
each of them? These two valedictions 
exemplify the attitude that the practice 
of medicine conflicts with rather than 
provides a source of personal fulfillment." 



ment reflected a society and School in 
which many of the changes so passion- 
ately agitated for in the preceding decade 
had taken root. The resolution of the 
polarizing generational conflict of the 
previous decade was evidenced in part 
by the renewed popularity of an exten- 
sively renovated Yanderbilt Hall in 1980. 
This once proud landmark had steadily 
deteriorated through decades of neglect 
into a shabby and, as one HMS dean 
described it, "dispiritedly unoccupied" 
dormitory. The overhaul of the physical 
plant was funded by alumni concerned 
about the erosion of Yanderbilt Hall as a 
social nucleus, a loss of collegiality that 
had accelerated in the 1960s. 

A new spirit of community was evi- 
dent at the School in this decade, with 
its commitment to achieving greater 
diversity among students and faculty, 
the struggle to reach out to underserved 


technologies have helped 
revolutionize education at 
HMS. In 1 996, students 
used "palmtops/' precur- 
sors to the Palm Pilots that 
today's students use. 

populations, and, above all, a sweeping 
reform of the HMS curriculum. The fun 
damental shift in pedagogical philosophy 
was inspired, in part, by increasingly 
vocal student disenchantment with the 
curriculum, a trend that the Bulletin had 
been documenting for some time. 

Indeed, at the beginning of the 1980s, 
not long before the curriculum overhaul 
took place, the Bulletin published the 
withering recollection of one member of 
the Class of 1967 who wrote that in his 
day at HMS, "the primary function of the 
medical school had been to make inroads 
in research. Students felt the pressure 
from this, which was about as subtle as a 
sledgehammer. The attitude then was 
that you'd learn what you needed to later, 
in practice. We felt cheated." 

Some 20 years later, a member of the 
Class of 1986 recorded strikingly similar 
misgivings: "As I sat in amphitheatres 
with my classmates and ghosts of alum- 
ni, trying desperately 'to learn,' I pon- 
dered how the material presented related 
to practicing medicine. Was memorizing 
tables and biochemical pathways crucial 
to my success in medicine? Where were 
the patients? I was not alone; the entire 
class seemed to lack perspective on how 
our daily studies were important to our 
ultimate patient responsibilities. This 
gap in my understanding remained until 
I was a third-year student confronted by 
clinical problems on the ward." 

To address this and other perceived 
shortcomings, HMS created the New 
Pathway, an innovative approach to 
training doctors. Charged by the dean 
to "think, from the ground up, about the 
essential ingredients 


of medical education," faculty and 
administrative planners spent two 
years crafting the program, which 
debuted in 1985. 

"The New Pathway curriculum," the 
Bulletin explained to alumni, "will be a 
continuum, interweaving the clinical and 
basic sciences, humanities, and social sci- 
ences bearing on medicine." Collabora- 
tion, active learning, questioning, prob- 
lem solving, and critical thinking were 
the new goals. Most crucially, students 
now had contact with patients from the 
very outset. Computer technology would 
also receive heavy new emphasis in this 
fresh approach to educating doctors. 




witnessed several developments that 
have had a major impact on the HMS 
educational experience. Continuing the 
trend that had begun with the 
advent of the New Pathway, 
the School made the 

technologies of the information revolu- 
tion an integral part of the curriculum, 
putting course materials online and 
equipping all students with Palm Pilots. 
The School also made a commitment to 
enhance learning with the creation of the 
Academy, a body dedicated to training 
and rewarding outstanding teachers. 

Recent years have also powerfully 
reflected a flowering of long-term 
efforts to make the HMS community 
more accurately reflect American soci- 
ety. As the 1990s progressed, so, too, did 
the transformative effects of the School's 
determined commitment to diversity, in 
the words of Dean Joseph Martin, "not 
as a question of fairness, but as a ques- 
tion of quality." 

In 1990, the School launched a pro- 
gram designed to bring greater diversity 
to the upper rungs of the ladder of aca- 
demic medicine. By mid-decade, women 
outnumbered men in an entering class 
at HMS for the first time, and students 
had established a research program 


THE SCHOOL MADE the technologies of the 
information revolution an integral part of the curriculum, putting 
course materials online and equipping all students with Palm Pilots. 

designed to attract Native Americans to 
medicine. By the decade's end, the dean 
had hosted a town meeting to address the 
issue of homophobia, which he described 
as "the last socially permissible bastion of 
prejudice." And the proportion of stu 
dents from underrepresented groups 
entering HMS better reflected their per 
centages in society as a whole. 

Yet despite gains, controversy over 
race-related issues continued to arise on 
occasion, most notably in the so-called 
Halloween incident of 1992, in which 
two white second- year HMS students 
costumed as Clarence Thomas and Anita 
Hill, with blackface makeup, had a scuf- 
fle with an African American first-year 
student at the annual Halloween party in 
Vanderbilt Hall. 

Well into the 1990s, in fact, a few dis 
senting voices, including that of a mem 
ber of the Class of 1937, expressed dis 
comfort with the changed face of HMS: 
"While attending my 60th reunion, I 
thought I would revisit Vanderbilt and 
see how things were going. It was like 
walking into some East Asian school — 
no responses to my greetings and much 
jabbering in foreign tongues." 

The final straw for this alumnus — 
and the one that prompted him to delete 
the School from his will — was a 1995 
Bulletin issue dedicated to the contribu- 
tions of women at HMS: "The cover 
awakened me (very sadly) as to what 
was going on at the Alma Mater. I am 

not prejudiced against women as doc 
tors, but the takeover of the School by 
affirmative action women students I 
cannot stand." 

To prepare tomorrow's physicians for 
the complexities of an increasingly mul- 
ticultural society and rapidly evolving 
technologies, HMS is currently undergo 
ing yet another redesign ot its curricu 
lum. The revised system will emphasize a 
holistic approach to patient care and the 
ability to synthesize information across a 

range ol disciplines 

Cultural competence — together with 
affinities for lifelong learning, communi 
cation, teamwork, leadership, compas 
sion, empathy, moral reasoning, sell 
awareness, and personal growth — is 
explicitly stated as a goal of the reforms 
under review. According to the working 
mission statement for this new educa- 
tional program, the School is "dedicated 
to the development of superbly educated 
physicians who will pursue careers in 
medicine characterized by humanism, 
scholarship, leadership, and discovery." 



Bulletin — like their Jazz Age counter 
parts — inhabit a world in rapid flux. 
Now, as then, the shadows of global 
conflict encroach on a promising terrain 

of economic expansion and scientific 
discovery. Now, as then, apprehension 
mixes with optimism as new technolo 
gies forever change the rhythms of daily 
life, the practice of medicine, and the 
culture of the classroom. 

When Elliott Cutler made his obser- 
vation 75 years ago that medical educa 
tion "runs in cycles, now long, now- 
short." he could not have foreseen the 
spectacular advances that lay on the 
horizon; in vitro fertilization, long dis- 
tance robotic surgery, and the decoding 
of the human genome would probably 
have sounded like the stuff of science 
fiction in his era, just as tomorrow's 
breakthroughs may one day seem to 
today's physicians. 

Yet for all the profound changes that 
social forces and world events have 
wrought at the School — some painful, 
many for the better — the educational 
mission of contemporary HMS remains 
predicated on values with which Cutler's 
generation could have identified. The 
most radical difference between past and 
present is perhaps the tremendous diver- 
sity that arose, at least in part, from the 
School's legacy of compassion, dignity, 
and thoughtful inquiry — values that are 
now transmitted to a far more richly 
inclusive audience than anyone might 
have dreamed possible in 1927. ■ 

Beverly Ballaro is associate editor of the 

Harvard Medical Alumni Bulletin. 



» V 

— *• 

Harvard alumni reflect on 

the births of modern 
medicine and surgery 




Alumni Bulletin debuted, a lanky instructor 
from Harvard Medical School slid into 
a sealed tin chamber, to which he had 
attached blowers from two household 
vacuum cleaners. The instructor, Philip 
Drinker, had found that he could ventilate 
paralyzed cats by placing them inside a 
chamber whose pressure he could raise 
and lower by pumping a handheld 
syringe. His own trial with the man-sized 
pressure chamber also proved successful; 
it forced so much air into him that 
he hyperventilated. The Iron Lung, as his 

TRAILBLAZERS: From top right: Philip Drinker, William 
Hinton '12, and Herrman Blumgart '21. Opposite 
page: Francis Peabody '07 (second from right) 
launched the highly productive Thorndike Memorial 
Laboratory at Boston City Hospital several years 
before his death in 1927 at the age of 45. 



respirator came to be known, 
eventually saved the lives of 
thousands of polio victims. 

That year saw other notable 
advances at Harvard Medical 
School. William Hinton '12, 
then an instructor and later 
the first African American to 
become a full professor at 
HMS, developed a state -of- 
the-art test for syphilis, a dis- 
ease that had brought disfig- 
urement, dementia, and death 
to untold millions over the 
centuries. And Herrman Blum- 
gart '21, also an instructor at 
HMS, helped usher in the age 
of nuclear medicine by using 
radioactive tracers to diagnose 
heart disease. 

The fledgling Bulletin did not 
record those advances and, 
indeed, for the past 75 years, 
it has seemed to take in stride 
the unfolding drama of med- 
ical research both at HMS and 
throughout the world. So we 
asked two alumni — a cardiolo- 
gist who lived through the 
golden age of medicine and a 
surgeon who began medical 
school the very year the Bulletin 
was launched — to recall some 
of their earliest experiences in 
witnessing the births of mod- 
ern medicine and surgery. 



Boston City Hospital when we came to the bed of a red-headed, freckled, and 
pale Irish lad. His neck had an obvious venous pulse and his chest was heav- 
ing. He was cheerful, despite signs of serious illness, and our instructor told 
us to listen to his chest for the loud murmur of mitral regurgitation. After 
we had done so and walked away, we were quietly told that this young man, 



WARD STORIES: Benedict F. Massell '31 
attends to a young patient at Boston's 
House of the Good Samaritan, one 
of a number of hospitals devoted to 
rheumatic fever and rheumatic heart 
disease in the 1 940s, when author 
Oglesby Paul '42 undertook his 
medical internship. 

barely 18 years old, was suffering from 
rheumatic heart disease, now compli 
cated by an infection of the mitral 
valve — bacterial endocarditis — and 
nothing could be done for him. Noth- 
ing could be done! Despite a good hos- 
pital, fine doctors, and a definite diag- 
nosis, this pleasant young man faced 
the same prognosis as an elderly man 
with terminal cancer. 

This was an era in which rheumatic 
fever and rheumatic heart disease were 
so common that entire hospitals — such 
as the House of the Good Samaritan in 
Boston, Irvington House in New York, 
and La Rabida Sanitarium in Chicago — 
were devoted exclusively to that condi- 
tion. In 1931, Alvin Coburn had report- 
ed how rheumatic fever followed infec- 
tion with the hemolytic streptococcus. 

The 1940s saw the rise of preventive 
programs using sulfa drugs. Still later 
came the successful treatment of the 
streptococcal infection itself with 
antibiotics. And later yet, these same 
agents were often used successfully 
in treating bacterial endocarditis. 
Rheumatic fever and its complications 
are now rare in the United States. But 
the young Irish patient's rheumatic and 
bacterial illness occurred before any of 
those cures were possible. This was a 
grim eye-opener for a medical stu 
dent — a lesson in the need for patience 
and hope for the future. 

The Old Man's Friend 


a phrase from John Bunyan, spoke of 
lobar pneumonia as the "captain of the 
men of death." In 1897, Osier wrote: "No 
other disease fells from one lourth to 
one third ol all persons aiiected" and 
"so fatal is it, that to die of pneumonia 
in this country is said to be the natural 
end of elderly people." 

In the early part of my career, I cared 
for a number of patients ill with the 
"captain of the men of death" but in an 
era in which lobar pneumonia was no 
longer as common or as lethal as in 
Osier's day. My first case was a middle 
aged physician, who was gravely ill in 
the Baker Memorial Unit of Massachu 
setts General Hospital. We had no 
antibiotics to offer, and we tried every- 
thing in our arsenal: sulfa drugs; type- 
specific antiserum; oxygen; expecto- 
rants; hot packs. Yet the poor lady still 
succumbed to her illness. 

And in the winter following the end 
of World War II, while at Chelsea Naval 
Hospital, I oversaw an acute medical 
ward with a number of such cases. It 

was Christmastime and many young 
enlisted patients who were not serious- 
ly ill were permitted to travel home for 
a holiday respite. As a result of the war, 
train service was irregular and the 
equipment poor. Many of the men 
returned from the southern states in 
railroad cars that were poorly heated 
and drafty. The men arrived back at 
Chelsea sick with respiratory infec 
tions, and about a dozen of them quick 
ly progressed to lobar pneumonia. 

Perhaps because of basic good 
health, all survived, though some devel- 
oped infected pleural effusions that 
required surgical drainage. A major fac- 
tor in their recovery was the availabili 
ty of the new drug penicillin, which 
was given intramuscularly. Penicillin 
was still scarce, and the doses adminis- 
tered would now appear grossly inade 
quate. Ten thousand units seemed like 
a heroic amount; it was only later that 
we learned to give much more if t he- 
patient was to reap adequate benefit — 
another lesson in patience. 

In Hindsight 


medicine, we admitted a stocky, 40-ish 
man with an acute myocardial infarc 
tion. At that time, physicians tended to 
view myocardial infarctions as unfortu 
nate acts of God, ignoring family histo- 
ry, the presence of high blood pressure, 
serum lipid levels, and any history of 
cigarette use. We had no coronary care 
unit, no thrombolysis, no platelet mod 
ifying drugs, no cardiac catheteriza- 
tion, no coronary angioplasty or stent 
ing, and no thought of surgery for such 
a condition. Patients who survived the 
initial insult were kept on strict bed 
rest for at least three weeks. 



tender loving care that we provided improved, or has 
it worsened? I strongly suspect the latter. 


This patient got into trouble on his 
second day of hospitalization when he 
needed to have a bowel movement and 
was given a bedpan. In retrospect, this 
was a stupid thing to have done, as the 
poor patient, already weakened by an 
acute heart muscle insult, had to defe- 
cate while maintaining a precarious 
balance on a hard metal surface. 
Perched on the bedpan, he suddenly 
had a cardiac arrest and died. I do not 
recall that we tried any cardiopul- 
monary resuscitation, as the current 
technique was not described for 
another 20 years, and there was no 
electrical cardioversion. I do not doubt 
that we attempted some futile maneu- 

ver, but the major advances that could 
have saved his life were years away. 

Pocket Cures 


cardiology, my early experiences in 
medicine briefly involved gastroenterol- 
ogy. The commonest condition that I 
observed as a student was duodenal 
ulcer. I remember how one of my class- 
mates who had developed such an ulcer 
used to creep quiedy out of rounds at 
Massachusetts General Hospital, hurry 
down to the cafeteria, gulp down a glass 
of milk, and then rush back to rejoin us. 
Our teacher was usually so absorbed in 

the discussion that he didn't realize the 
student was missing. 

I next saw duodenal ulcer as a major 
health issue when I was assigned to a 
Chelsea Naval Hospital ward that was 
full of young sailors, 90 percent of 
whom were there because of duodenal 
ulcers. Treatment consisted of ant- 
acids, bland diet, rest, and time. We 
never considered the possibility of an 
infectious agent, and if it had been pro- 
posed at the time, we would have sure- 
ly labeled it as rubbish. 

When I moved to Chicago in 1948, 1 
soon realized that the city was a 
breeding ground for ulcers, and many 
a gastroenterologist earned his living 


York Hospital in the 1 930s, when 
author George Dunlop '31 under- 
took his surgical internship there. 



by caring for patients with this condi 
tion. My first office was in the People's 
Gas Company building, a most appro- 
priate name given the nature of the 
specialists housed therein. I recall 
how, on his rounds, Bertram Sippy of 
Sippy Powder tame would sometimes 
encounter a patient complaining of 
constipation produced by his antacid 
powders. At that. Dr. Sippy would 
produce from his pocket a bar of soap 
and cut off a suitably sized suppository 
which he gave to the patient. There was 
a saying in Chicago at the time that 
Dr. Sippy not only gave "hope for every 
soul, but soap for every hole." 

The Price of Progress 


treatments and outlooks for the four 
conditions with which I'd had so much 
experience: bacterial endocarditis, lobar 
pneumonia, myocardial infarction, and 
duodenal ulcer. The prevalence ot some 

underlying diseases, such as rheumatic 
fever, has been drastically reduced in 
the Western world, and deaths from 
coronary heart disease and lobar pneu- 
monia have declined. The duration of 
hospitalization for these and most other 
illnesses has been markedly shortened. 
Yet one has to wonder: has the tender 
loving care that wc provided also 
improved, or has it worsened? I strong- 
ly suspect the latter. 

Scientilic breakthroughs have trans- 
formed the culture of medical schools 
and teaching hospitals, but the contem- 
porary emphasis on technology has 
come with a penalty. The humanistic 
aspect of medicine, the centrality of the 
patient as a human being, has been sac- 
rificed. The old norm of the physician 
as an understanding and communica- 
tive figure who had the time to get to 
know patients' family circumstances 
and financial situations is largely a phe- 
nomenon of the past. Patients were 
then, as they are now, deeply apprecia- 

tive of the concerned rapport that good 
doctors developed with them. Yet the 
very technological advances that have 
improved care have also made for 
increasingly depersonalized relation- 
ships between physicians and patients. 
Perhaps some words of a bygone 
golden age, uttered by the Scottish 
author and statesman John Buchan at 
my 1938 Harvard College graduation, 
are applicable: "Life was more interest- 
ing than can ever have been before," he 
said. "Men were bolder and more 
humorous; friendship was a rich and 
warmer thing; the world was a succu- 
lent oyster waiting to be opened. 
Brightness has fallen from the air and 
the twilight of the gods has descended. 
The few good men left from that time 
arc now growing old, but they are deter- 
mined to testify to unbelievers of the 
great era in which they once Lived." ■ 

Oglesby Paul '42 is professor of medicine 
emeritus at Harvard Medical School. 


w/ &e 

r w *ye&/y. 




who wanted Co become surgeons learned their art by apprenticing themselves 
to experienced surgeons, whose practice they often joined once their training 
was complete. Residency programs, as we now know them, hardly existed, 
and competition for the limited number of available spots was fierce. So when, 
fresh out of HMS, I moved to New York City to pursue a surgical residency, I 
counted myself fortunate indeed. ■ It was a monastic existence, but the other 
residents and I loved what we were doing. The hospital provided room, board, 
and uniforms. A first-year man was paid S26 a month, a second-year man. 

$50, and a senior resident earned the 
princely wage of $100. We didn't go 
out on very many New York binges, 
however; I once spent six consecutive 
months without setting foot outside 
the hospital during daylight hours. 
When I did get out at night, there 
wasn't too much trouble to get into. 
Prohibition was still in force, and the 
headlines were full of speakeasy raids 
and the rumrunner culture of Al 
Capone. One time, I managed to find 
someone to cover my cases so I could 
spend a rare afternoon in Manhattan. 
When I returned to the wards, my 
fellow residents peppered me with 
questions about life on the outside. I 
joked that women's skirts seemed to 
haw gotten considerably shorter! 

Unlike today, when so much 
research is carried out by those with 
doctorates, in the old days even young 
physicians had many opportunities to 
make their mark on the profession. 



LOOK," I TOLD HIM, 4 T11 give you my automobile, 
I'll give you my wife, but I'm not giving you my aorta!" 


While still a resident, I published a 
paper based on an idea that had come 
to me during my surgical pathology 
rotation. We had been learning to 
diagnose thyroid cancer by seeing can- 
cer cells in small capillaries placed 
under a microscope. I reasoned that 
because we were finding them in the 
capillaries, these cells must exist in 
the circulation. I began collecting 
blood samples from cancer patients 
and, sure enough, was able to identify 
free-floating malignant cells. 

But the most exciting medical break- 
throughs I saw came in the field of vas- 
cular surgery. Although I had been 
trained as a general surgeon, as was the 
practice in those pre-specialized times, 
I happened to witness the birth of a 
new surgical field. 

The Big Chill 


our tools and techniques were primitive 
by today's standards. Back in the 1920s, 
for example, the best treatment for 
aneurysms consisted of threading wire 
from a sterile spool into the aneurysm in 
the hope of creating a clot. The notion of 
replacing an aneurysm in one human 
being with a blood vessel taken from 
another human being seemed as far 
from reality as space travel, but it was 
an idea that had always intrigued the 
profession. I, too, dreamed about such 
a breakthrough, especially after I wit- 
nessed the devastating consequences of 
a ruptured aneurysm. 

Even though many decades have 
passed, I can still vividly recall seeing 
one patient who was brought into the 
hospital suffering from an aneurysm of 
the thoracic artery that had eroded all 
the way through his sternum. When it 
ruptured, the force was such that the 

blood spewed all the way across the 
hospital room, hitting the far wall. 
That incident really made an impres- 
sion on me. 

So, about five decades ago, when I 
received an invitation from the chief 
of surgery at St. Mary's Hospital in 
London to view an experimental type 
of vascular surgery, I jumped at the 
chance. The patient was a middle-aged 
woman who had recovered from a 
series of nearly 50 transient ischemic 
attacks. The woman's strokes were 
caused by arteriosclerosis in her 
carotid artery, and her doctors knew 
that it was only a matter of time before 
a major event would prove incapaci- 
tating or fatal. 

In those days, there was no such 
thing as an angiogram, so the team had 
ascertained the presence of the block- 
age by listening with a stethoscope 
applied to the patient's neck for a dis- 
tinctive whistling noise where there 
should have been only silence. The 
plan was to open up her neck and 
either clean out the artery or remove 
it. But if they were to clamp the 
woman's cerebral artery for more than 
five minutes, they wxjuld risk damag- 
ing her brain. 

The St. Mary's team put together a 
bold strategy to buy themselves pre- 
cious time. They decided to transfuse 
blood into the patient's artery rather 
than a vein, to speed up the delivery of 
oxygen to her brain. To overcome the 
problem of the tremendous pressure in 
the arteries, they suspended the bag of 
blood from the great height of the oper- 
ating balcony ceiling. 

Also, they knew then, from the 
experiences of children who had near 
ly drowned in frigid waters and sur- 
vived unscathed, that brain cells tol- 
erate reduced oxygen better at low- 

temperatures. So the team anes- 
thetized the patient, placed 24 bags of 
ice upon her naked body, and turned 
on electric fans to circulate the Febru- 
ary chill through the opened windows 
of the operating room. The nurses, 
clad in long underwear, kept watch 
over the patient for two hours while 
the surgeons waited for the cold to 
take effect. 

When the team finally entered the 
operating room, I followed, camera in 
hand. What I witnessed and docu- 
mented with photos truly was history 
in the making: the first successful 
carotid endarterectomy ever per- 
formed, as reported in The Lancet in 
1954. Harry Hubert Grayson Eastcott, 
who performed the operation, con- 
tacted me not long ago and told me 
that I'm the only other person alive 
with eyewitness knowledge of the 
first carotid endarterectomy. 

When I returned to Worcester 
Memorial Hospital, I carried out many 
of these procedures, using a thermal 
blanket — which I found more effective 
than ice bags — to lower my patients' 
body temperatures. Ironically, the chief 
of surgery who had supervised that 
landmark operation in London had to 
undergo the procedure on his own 
carotid artery years later; he recovered 
but died of a heart attack not long 
after. Today, more than 250.000 of 
these operations are performed around 
the world every year. 

Lessons from the Heart 


attempted to transplant an artery or to 
use a vein as a bypass. At Worcester 
Memorial Hospital, surgeons eventual 
ly began to try to bypass blocked arter 
ies using veins, which worked well 



COLD FEAT: In 1954, George Dunlop 
photographed the world's first 
successful carotid endarterectomy. 
The surgeons placed two dozen bags 
of ice on the patient to help keep her 
core temperature low enough. 

enough in larger arteries but not in 
smaller vessels. I remember the relict I 
felt when a famous London surgeon, 
who was an expert in the field, 
declared, "It makes no sense to attempt 
vascular surgery below the groin." At 
that point, I stopped focusing my 
efforts on smaller arteries and began 
concentrating on the larger ones. With 
this in mind. I asked the pathologist at 
the Worcester hospitals to please save 
me an aorta from a cadaver if a suitable 
one ever became available. 

Many months passed before, late one 
night, I received a phone call. A young 
man had been killed while attempting 
to cross a railroad track. The patholo- 
gist harvested the young maris aorta. 

which was sterilized with high voltage 
radiation at MIT. The precious tissue 
was then stored in a sterile glass tube, 
which was packed in dry ice and 
shipped to the hospital for deep freeze 
storage. I remember that, at one point, a 
colleague approached me and said, 
"Hey George, 1 hear you have an aorta. 
\n\ chance 1 could use it?" "Look," I 
told him, "I'll give you my automobile, 
I'll give you my wife, but I'm not giving 
you my aorta!" 

Some time later, I received word that 
the hospital had admitted a middle 
aged schoolteacher with a leaking aortic 
aneurysm. Alter learning the details of 
the case, I knew that this was the 
moment for which I had spent two 

wars researching, reading, and prepar- 
ing. I got the patient on the operating 
table, opened up his abdomen, found 
the slowly oozing balloon, and then 
sent down for the aorta. You can imag- 
ine my chagrin when the nurse reported 
that the freezer was locked up tight and 
the key nowhere to be found! To make 
matters worse, the hospital superinten- 
dent who had the key was on vacation 
in Canada. We put our heads together, 
and finally someone thought of contact- 
ing one of the off-duty nurses in the 
hope that she might have a copy 7 . We all 
breathed an enormous sigh of relief 
w hen she drove a key over to the hospi- 
tal from her home across town. 

I put in the aorta and the patient 
recovered. The family had promised me 
that it the patient died, I had their per 
mission tor an autopsy. Less than two 
years later, he did die ot a heart attack 
and the postmortem examination was 
conducted. When I examined the aorta, 
I was stunned to see that it was com- 
pletely shaggy with arteriosclerosis; it 
had taken the patient's body less than 
two years to age tissue originally taken 
from a 17- year-old to a state similar to 
what we would expect to find in a dis- 
eased elderly man. 

So we learned something new. Even 
tually, Dacron came into use as a syn- 
thetic substitute — after researchers lit- 
erally worked the kinks out — and it 
continues to be used to this day. 
Through trial and error, persistence 
and patience, we gained the knowl- 
edge necessary to save many lives that 
in the past we would have been help- 
less to preserve. ■ 

George Dunlop '31, professor emeritus of 
surgery at the University of Massachii^U\ 
Memorial Hospital practieed surgery for 
more than 60 years. 




J V' 


Harvard Medical Alumni Bulletin 
readers have been dispensing 

editorial advice for the past 75 years 


The alumni will just freak!" The warning came several 
years ago, early in my tenure as editor of the Bulletin. 
"Use the word L refresh,'" my predecessor advised. 
"Assure them that you'll only be tweaking it." 

She cautioned me, too, that some alumni harbored 
proprietary feelings about the Bulletin. After all, they had 
been reading it — and writing much of it — for decades. 
She mentioned one alumnus in particular, a pioneer in 
surgery, a brilliant mentor, and an object of terror for gen- 
erations of medical students. Sure enough, it wasn't long 
before Francis Moore '39 called to check on the new edi- 
tor. When I slipped into the conversation my thoughts 
about a redesign, he didn't speak for a full minute. "Young 
lady," he finally intoned, "you must treat the Bulletin 
reverently. The Bulletin" — here he paused for emphasis — 
"is like Shakespeare and the Bible." 


;arnifi)t in of; - 

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me conceit I 










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It was then that I understood: this was no ordinary 
alumni magazine. Suddenly I felt the indecision of Hamlet, 
the hesitation of Abraham. With Dr. Moore's injunction 
still ringing in my ears, I studied the Bulletin's pages again. 
The magazine hadn't changed in nearly a decade, and 
even then the alterations had been modest. The pages 
were often gray, the images sometimes static. And yet the 
prose was compelling. A second color would certainly 
brighten the pages; a more dramatic design would render 
the text more inviting. 

With some trepidation, I uttered the word "redesign" 
at an Alumni Council meeting. When no one flinched, 
the editor-in-chief and I exchanged a glance. Embold- 
ened, we launched a new design in the summer of 1999. 
For the first time in the seven decades of its existence, the 
magazine gained a second color on its interior pages. A 
silhouette of Elvis in full gyration illustrated musical 
preferences in the operating room. A series of increasingly 
muscle-bound G.I.Joe action figures revealed the danger- 
ous evolution of male body ideals. An astronaut floated, 
untethered, across a magazine spread. 

The phone rang, and the verdict was in. "I like it," 
Dr. Moore growled. "But don't let your designer go crazy." 



examining the magazine, diagnosing its ailments, and 
writing sometimes pungent prescriptions for its recovery. 
Founding editor Joseph Garland '19 had encouraged a 
sense of ownership among the alumni from the outset: 
"It is your Bulletin — you should have a hand in deciding 
what sort of bulletin it should be." 

For the most part, his strategy seems to have worked, as 
readers have more often praised the magazine than panned 
it. "From cover to cover, the Bulletin is splendid," William 
Castle '21, a towering figure in the history of medicine at 
Harvard, declared in 1951. "It's wise, it's witty, it's human. 
I hope that all who see it will feel a deeper pride and, yes — 
joy — at being an alumnus of HMS." 

Even those bent on criticizing the Bulletin found laudable 
elements. When asked, in 1972, to write an article for what 
he assumed to be a stodgy magazine, one young physician at 
first found his worst suspicions confirmed. "The parochial 
ism and narrowness of vision were evident enough," he 
wTote. "E\ident, too, was the almost pathological involution 
which seems all too characteristic of alumni publications." 

J&asvA 7 /<9J>7- 


Bulletin debuted in the spring of 
1927, to the near-universal praise 
of Harvard Medical School alumni. 
Earlier attempts to create a bulletin 
had faded quickly. 



inaugural Number 


M»tch. 1927 

J&v&n^/gJ/- -i jfywf/S&f- 

SMELL AS SWEET: In 1 93 1 , for the first 
time, the cover of the magazine reflected 
its current name. This small, basic format 
was followed until the mid-1 940s. 


use a second color on the cover, the April 
1944 issue was introduced with: "After 16 
years in the familiar black-on-white garb, 
your Bulletin herewith sheds its skin and 
emerges fully clad from the head of. ..(Ed. 
Note: The metaphor was blocked just in 
time and we went to press, happily, with- 
out any scrambled mythology.)" 


°vem/, er 



.«MOCI»*"- ,S 


Yet once the physician "mustered the courage to get past 
the cover," he found "not only a spirited exchange on the 
war in Vietnam, but a very nearly militant attack on fee 
for-service medicine. Another issue included a sensitive 
piece on emergency medical care in East Pakistan — albeit 
sandwiched between Libritabs and Valium, Class Notes 
and Charter Flights. Genuine issues, genuine feelings, 
seemed undeniably to be slinking into these staid pages." 

Such slinking was, to a great extent, just what the editor 
had ordered. Since the magazine's inception, the editors 
have sought to coax impassioned responses out of their 
readers. "We have suffered from a lack of burning issues," 
Garland wrote in 1928. "Any graduate who has an actively 
burning issue is invited to send it in, but it must be no smol- 
dering, damp affair. It is not smoke we want, but a fierce 
and burning flame. We had conceived the idea of offering 
cash prizes for burning issues but the treasurer soon put a 
stop to that." Years later, editor George Richardson '46 
proclaimed, "We prefer provocation to sedation, and rather 
fancy ourselves as a magazine of true adventure." 

Readers themselves debated whether the Bulletin should 
provoke more and sedate less. In 1955, one alumnus 
accused the magazine ol skirting controversial issues. 

"Let's have more light and less sweetness," he urged, sign 
ing his letter "Pugnax '41." 

"Irritated '35" shot back: "Pugnax's demands that the 
Bulletin rush headlong into controversial issues of medical 
politics, ethics, and economics are either ridiculously 
puerile or shrewdly aimed at bringing about the sell 
destruction of the paper. He should leave the Bulletin to 
pursue its excellent course undisturbed. Personally, I 
regard his suggestions as asinine." 


Although "Pugnax" and "Irritated" had graduated only 
six years apart, the condemnation of the younger corre- 
spondent as "puerile" is telling, for opinions about the 
magazine's contents have tended to reflect the genera- 
tional sensibilities of the Bulletin's readers, who range in age 
from their early 20s to late 90s. 

"Please — what has the Bulletin to do with that giant 
conclave of pigs at Woodstock?" a member of the Class ol 
1943B demanded in 1975. "It's supposed to be an alumni 
magazine, but it's completely dominated by the snot- 
noses of the 70s. Strike me off your list, gentlemen. Once 
and for all." (His name clearly stayed on the list, for sev 
eral years later he was still inveighing against all the 
"tomfoolery" to be found in the Bulletin.) 




ALAS, POOR YORICK: The June 1953 
issue featured a debate over "the 
world's most perfect skeleton," a con- 
troversial moniker given to a skeleton in 
Harvard's Warren Anatomical Museum. 
This Bulletin style lasted two years. 

<9c/r/w //;.;.; 

editor John Merrill introduced this 
updated look in January 1955, he 
wrote, "With this issue the Bulletin 
appears in new garb; larger, more 
easily read, and, we hope, more 
attractive. The format is improved, 
and the content will not lag." This 
approach was retained through 1 960. 

I — 

^stun^ve/* /S6~6*- 


In the 1960s, the Bulletin's covers 
became more varied. One reader 
responded to the one below with, 
"What has gotten into your editorial 
board, approving the current cover 
as it has? Some recent numbers have 
been pretty bad, but this one passes 
all bounds." 

r A 





A presumably aggrieved "snotnose" defended the maga- 
zine's Woodstock coverage, arguing, "By its focus on cur 
rent issues that touch medicine in its broadest human 
sense, the Bulletin has metamorphosed over the years from a 
somewhat creaky vehicle into an exciting, vital, and occa- 
sionally passionate forum for ideas and debate, which I look 
forward to reading with each new issue." 

Intergenerational conflict did not cease with the pass- 
ing of the controversial Woodstock era. "It saddens me that 
the Bulletin seems to have degenerated into a series of shrill, 
sophomoric essays by medical undergraduates who fancy 
themselves to be 'dehumanized,' " an older alumnus com- 
plained in 1982. "Has the whole HMS student body 
become a group of dyspeptic little Hamlets who mope 
about constantly ruminating and soul searching? Please, 
let's return to the old Bulletin, and have something which 
'neither starveth the soul nor outrageth the intellect.'" 



to nourish both soul and intellect. "Our Bulletin will con- 
tinue to represent a refreshing sounding board for alumni," 
editor John Brooks '43B wrote in the magazine's 40th 
anniversary issue, "so that all may express themselves in 
areas not purely scientific or clinical, but rather in ways 



vr//y /£Z9 

two younger alumni praised what they called 
the "brilliantly executed and conceived satire 
of a now famous New Yorker cover," an older 
alumnus declared that it had been done "in 
execrable taste." 

PLEASE THE EYE: In the 1970s, the Bulletin's 
covers were often printed in full color. The 
interior pages continued to be printed in 
black and white, with occasional splurges 
on full-color features. 

whereby they can maintain the breadth of pursuit that 
makes for the happy life of the doctor. Medical politics 
and community health, medical law and insurance, trav- 
el, hobbies, and humor: these are the pursuits that keep 
the doctor from being a narrow man." 

With most of the articles written by HMS graduates 
themselves, the Bulletin has, over the years, delved into 
some wonderfully offbeat topics: Sherlock Holmes's affec- 
tion for dogs; miniature recreations of infamous murder 
scenes; the seven Sutherland sisters, whose combined 
tresses measured nearly 37 feet. Even medical stories have 
explored quirky angles: diagnoses of the maladies of liter- 
ary characters; clinical encounters with whales in distress 
and chimps in traction; visual correspondences between 
art and anatomy, with Vincent Van Gogh's Starry Night 
resembling ovarian tissue samples from rats. 

Such courageous eclecticism has not, however, satis- 
fied all readers. In 1979, one alumnus reported that a 
classmate had been urging him to write an article on a 
"delectable but much maligned vegetable" — the parsnip: 
"Of course, I was a bit puzzled by the idea of the parsnip 
as a subject for the Bulletin. It does not cure acne, it does 

E*t 1782 




":, , JA ■ >-^0D /^. T&F 


nothing for hypertension, and schizo 
phrenics are unmoved by it (except in 
certain instances in which they have been 
observed to spit it out quite ungracious- 
ly). Why then for the Bulletin? The latest 
issue led me to discard my scruples. The 
reason — an obvious lack of material. So 
why not parsnips?" 



of content 1 — or lack of choice content — 
have represented but one form of gleeful 
criticism by the magazine's audience. Pars- 
ing the Bulletins prose, discerning readers 
have seized upon lapses in language, pec- 
cadilloes in punctuation, and sins in syn- 
tax. One reader, taking the Bulletin to task 
for several mistakes, noted crisply that, 
with regard to prescriptions and inscrip 
tions, "your critic hopes for accuracy in the 
former, but would enjoy it in the latter." 

Another reader labeled the misidentiti 
cation of a photograph an "unseemly prac- 
tical joke" on the part of editor George Richardson. "I pre 
sume he has skipped town," the offended party wrote, "and 
therefore demand an abject apology in the next issue of 
your rag. Our class will not be in town again until our 50th 
reunion; but at that time if the editor has sneaked back, we 
will be glad to ride him out on a rail, suitably clad in tar and 
leathers." ("Since reading this peevish epistle," Richardson 
responded, "I have oscillated between challenging the 
writer to a duel and eating crow. I have elected to eat crow. 
Mea culpa! Mea gravissima culpa!") 

A question posed in a 1964 article — "Surely, by then 
diabetes may be no more threatening than to be born now 
with such errors of metabolism as phenylketonuria and 
congenital hypothyroidism?" — led another reader to 
wonder whether "the syntax was veiled in a membrane 
too tough for the surgical skill of the editor. 

"Whenever time hangs heavy on my hands," the critic 
wrote, "I can always go back to this interrogation and try 
to decipher it. I have tried the cryptographic approach, 
such as omitting every third word and then taking every 
second letter of what remains, always being careful to 
transpose the d and the b. So far this hasn't clarified the 
question. An alternative would be the cabalistic approach, 
where the initial letters of each word correspond to 
numbers of special metaphysical significance known only 
to the initiated. 


. /////////r/' /-9 S'/ 

FULL OF SOUND AND FURY: Dubbed the Awful, 
Awful Issue, the Summer 1981 Bulletin was likened 
to everything from a parody of movie magazines 
to an inflamed carbuncle. One reader griped, 
"The shifting type size, tilted pictures, broken 
columns, and pop art constantly pried me 
from the pleasantly thoughtful experience that 
reading the Bulletin has always been." 


"I have even considered the psychiatric approach, 
considering the whole sentence a gigantic Freudian slip," the 
reader continued, "indicating that the author was probably 
a bottle fed baby expressing some latent resentment against 
his mother. Or perhaps someone failed to exorcise the devils 
who lurk in the bowels of linotype machines and cause the 
flatulence which becomes manifest in the printed word." 



grumbled about the Bulletins content, readers have often 
saved their most devastating diagnoses for the magazine's 
design. In the 1960s, readers urged a return to the format of 
the 1950s; in the 1970s, they pleaded for some flair. In the 
1980s, they yearned for the 1970s look; a decade later, they 
accused the magazine of trying too hard to be trendy. 

"What has gotten into your editorial board, approving 
the current cover as it has?" one alumnus griped in 1966. 
"While the rest of your alumni body are busy improving a 
cockeyed world by providing therapy, your board is taking 
the easy path, and helping in the general degeneration. If 
you intend to keep on with these childish pranks, please 
don't send any more copies to my office. The Columbia doc- 
tor next to me saw that cover and laughingly asked whether 
our board members really are Harvard Medical graduates." 






■> ////■ - j/a/// sy/ /s///r/) /s//v< //■)//////// /'f/r///yrs//r s/ //yv//s/// 



preparing to launch an ambitious redesign of the Bulletin. 
He had articles to edit, design details to approve, 
Nobelists to laud. That same month, he broke new ground 
in his day job as well, serving as head physician on 
the team that performed the world's first successful kidney 
transplant in humans. 

How did this moonlighting nephrologist juggle both jobs? The 
same way that Bulletin editors have been finessing their duties for 
decades: "With the indispensable help," as 
founding editor Joseph Garland '19 once 
noted, "of extraordinarily well-qualified lady 
associate and assistant editors." 

When Garland introduced the Bulletin in 
1927, it was, he wrote, "a one-man job, 
performed when time permitted." Time has 
seldom permitted, however, as all of the 
Bulletin's alumni editors have been practic- 
ing physicians. Along with Merrill and Gar- 
land, a pediatrician, they have included a 
cardiologist, a rheumatologist, two psychia- 
trists, an internist, and — appropriately 
for the task of editing — five surgeons. 

The idea of adding a woman's touch 
first arose in 1 93 1 . "A powerful stabilizing 
factor," editor James Faulkner '24 wrote, 
"would be the employment of an experi- 
enced professional secretary, preferably 
with some journalistic training, who would carry on the bulk 
of the detail work of editing the Bulletin." 

Mrs. K. B. Wilson became the magazine's first staff mem- 
ber in 1936, as part of her role as the Alumni Association's 
executive secretary. "During the years she has suffered nobly 
(and not always in silence)," editor Edward Hamlin, Jr. '33 
wrote a decade later. "Mrs. Wilson's faithful supervision of each 
Bulletin has been of the utmost help to the various editors, 

who must fit their editorial duties into their own busy medical 
schedules." Hamlin added, "The editor understands so little of 
his job that problems are practically unknown." 

Since then, 35 ladies and one gentleman have provided the 
behind-the-scenes editorial assistance. As the task of publishing 
the Bulletin grew increasingly complex, editor George Richardson 
'46 drew a parallel between their efforts and the activity por- 
trayed in "the New Yorker drawing of the Cadillac hood, open at 
the gas station, with two exhausted squirrels in a cage in place 
of an engine." The ladies' exhaustion may 
have sprung from a high level of commit- 
ment; in 1962, the associate editor raised 
the bar of devotion by resigning from her 
desk just four hours before giving birth to a 
daughter at the Boston Lying-in Hospital, 
conveniently located across the street. 

In 1995, coincident with the publica- 
tion of a special issue celebrating the 
50th anniversary of the admission of 
women to Harvard Medical School, the 
managing editor position was upgraded 
to that of editor, and the physician editor 
became listed as editor-in-chief. 

"Soon after joining the Bulletin I was 
charged with interviewing a candidate for 
the associate editor's position," says 
William Bennett '68, the incumbent editor- 
in-chief. "A sprightly young woman, she 
sat down with me and said engagingly, 'I know you're pretty 
much a figurehead, but I'd like to tell you about my experience.' 
I'd like to think I'm not entirely a figurehead, but reflecting on 
the history of my predecessors and their 'lady editors' has 
redoubled my admiration for the skillful balancing acts — 
whether between the Bulletin and dedication to practice, or 
between the Bulletin and devotion to family — that have kept 
the magazine going strong for 75 years." 

"1 am a firm believer in style," another alumnus declared 
a decade later. "Your Bulletin lacks style. From a typograph 
ic standpoint, it is so drab, so soporific — it's abominable. I 
have complained before; I will complain again. Why not 
walk down the street to the New England Journal of Medicine 
and see how they do it? It's not the best format in the world 
but it's light-years ahead of yours. Please let me read the 
Bulletin with pleasure. Please get up some style." 

Several years later, an alumnus denounced the "exe- 
crable taste" of a Bulletin cover that mimicked the famous 
New Yorker map of the world. "This serious travesty at 
alumni expense will be reflected in annual giving," he 

warned. "If the Bulletin feels that this is appropriate filler 
for its pages, I suggest that we begin a diligent search for 
a new editorial staff. If it has no further choice, I suggest 
that the office be closed." 

Yet the Bulletin's most acute affliction, according to its 
many diagnosticians, flared up in the summer of 1981. That 
issue sported a new look, the result of "some cosmetic 
surgery," as the editor's column optimistically framed 
it. Day Glo colors electrified the cover's celebratory 
photomontage, turning balloons vermilion, ribbons 
pistachio, and frosting fuchsia. The tilted reunion photos 
were tightly cropped, lopping off many a physician's head 



^y//v'//s/ X# S'^ 


School's bicentennial was commemorated 

with a special issue whose cover was 

adorned with portraits of two of Harvard 

Medical School's founding faculty members, 

John Warren and Benjamin Waterhouse. 

at mid temple. Illustrations depicted everything Irom 
Lilliputian doctors scouring a Brobdingnagian ribcage 
with magnifying glasses, to a Los Angeles freeway swirling 
through a Chinese landscape, to a shark circling above a 
submerged dentist, armed only with the dental probe, 
mirror, and toothbrush stowed neatly in his pocket. 

The bold design drew high praise from publishing 
professionals. "Your transformed Bulletin made waves in our 
office this morning," one wrote. "When the mail came in, 
our publications staff dropped everything to gawk." 
Another observed that the magazine's excellent contents 
had been wrapped in drab packaging for far too long. "But," 
he predicted, "you are sure to hear howls of protest from 
those to whom tradition has no rival." 

And howl they did. "Ugh! I do not like the new Format," 
one alumnus wrote. "The type is unattractive. The artwork 
is ugly, ugly, ugly. It looks as if you have gone modernistic, 
and the Bulletin looks like a cheap trade journal. Is this a 
sign of deterioration of the X ledical School, or of the mod- 
ernists who have taken over? Thank goodness I was in 
medical school when it had dignity!" 

A second alumnus lamented the magazine's resemblance 
to "a pharmaceutical house publication with touches of the 
Victorian Age." Another condemned what he viewed as an 
ill conceived foray into pop culture: "II People magazine 

were what I wanted to read, I might not have bothered with 
the Bulletin in the first place." A fourth noted, curtly, "Cover: 
nauseating. Typography and layout: appalling. Drawing and 
'artwork': pathetic. Overall: disastrous." 

Perhaps the most unnerving diagnosis came from an 
alumnus who laced his epithets with clinical terms: "I 
have been trying to analyze what is so repulsive about the 
latest issue of the Bulletin, and have finally come to the 
conclusion that it's not the literary copy but, like an 
inflamed carbuncle, it hurts just to look at it. 

"I am not the only one left speechless by the banality 
and cyanotic quality of the cover picture and illustrations 
in general," he added. "As if that innovative balderdash 
were not emetic enough, on opening the cover one is 
slapped promptly with staccato changes in type and head- 
lines that flash out as blatantly as the bleats and beats of 
a rock concert." The issue, the alumnus concluded, was 
simply a "malformation." 

In his farewell column more than a decade later, editor 
J. Gordon Scannell '40 was still alluding to the trauma, label 
ing it "an editorial fiasco." The cautionary tale of the Awful, 
Awful Issue, as it came to be known, has since been passed 
down to each incoming editor. Clinging to a familiar prin 
ciple, "First, do no harm," the Bulletin's chastened guardians 




Bulletin undertook a redesign that lasted nine 
years. "No radical reconstructive surgery, 
mind you," editor J.Gordon Scannell wrote. 
"Just tasteful cosmesis." 


magazine was redesigned in the summer 
of 1 999 — despite repeated admonitions 
against tinkering with its design — this 
issue became the first to incorporate a 
second color throughout its inside pages. 

have since carefully avoided taking any but the most 
palliative of measures; readers, for their part, seem to have 
adopted an approach of watchful waiting. 



and during my short tenure at the Bulletin I've not been 
immune. Indeed, a year before his death last November, 
Francis Moore called to dispute an article we had pub- 
lished about an infamous murder that took place at Har- 
vard Medical School in 1849. By then, I had learned to con- 
sult with Dr. Moore on everything from his experiences 
during World War II (investigating new treatments for 
wartime casualties), to his musical preferences while oper 
ating (silence, interrupted only by "kind words, if not 
sweet words" from his scrub nurse). And by then, I had 
come to recognize the warmth in his baritone and the play- 
fulness of his words — even his reproving words. Didn t I 
realize, he asked, exasperated, that Professor John Web- 
ster was not guilty of murdering his old friend George 
Parkman, as had been presumed for 150 years? 

Dr. Moore promised to set the matter straight and was 
delighted when we published his entire letter to the editor, 
which ran nearly half the length of the original article. His 
missive argued for the homicidal culpability of the School's 
janitor, then concluded with the hope that the Bulletin's editor 
of 50 years hence — "as yet unborn" — would display better 
powers of discernment than those of the current editor. 

More recently, a reader evoked the very bard that 
Dr. Moore had encouraged me to bear in mind. After 
soundly castigating the author of a Bulletin article, she 
concluded her letter with, "There is no point in going on 
about the hellish philistinism of this man. I leave it to 
Shakespeare and King Lear. The author stands convicted 
as surely as if he were the odious Goneril, whom Albany 
rightly condemned with searing words: 'O Goneril! You 
are not worth the dust which the rude wind blows in 
your face.'" 

Before we could go to press, the reader withdrew her 
letter, admitting that she had composed it in a fit of pique. 
We can't always count on such felicity, though, so we con- 
tinue to tread softly, filling the Bulletin's pages with some 
sweetness, some light, and the occasional burning issue. 
And when our contents run dry, we know we can always 
refill one of the magazine's many prescriptions: editing by 
cryptographic or cabalistic approach, celebrating the 
much neglected parsnip, or simply thumbing through 
pages of Shakespeare and the Bible, seeking inspiration. ■ 

Paula Byron is editor of the Harvard Medical Alumni Bulletin. 



unprecedented popularity of the Winter 

2000 cover proved the old adage about 

the show-stealing properties of babies 

and dogs. We await canine opportunities. 



/'-""' inception todcath 


Shuffling Off to Buffalo 

A sentence in the recent issue reminds 
me of the old New Yorker quips: 
"Clement was a psychiatrist who special- 
ized in the treatment of alcoholism on 
the staff of Buffalo General Hospital." 
Buffalo is a tough place to live but... 

From the Bottom of My Heart 

Though on occasion rectal examination 
or dilatation may indeed induce 
extrasystoles or even syncope from sinus 
standstill, and straining at stool may 
bring about serious pulmonary 
embolism, I hasten to correct any impres- 
sion of Leonardesque versatility con- 
veyed by the title given for my book in 
the Alumni Notes section of the last issue 
of the Bulletin. It should read "Cardiac 
Emergencies and Related Disorders," 
rather than "Rectal Disorders." However, 
the surprising interest in the quoted title 
suggests that perhaps the subject as 
given deserves greater attention. 

How Do You Like Them Apples? 

In the July 1 957 issue of the Bulletin, I 
find: "Leslie M. Bell reports that he keeps 
busy doing in the 'apple country' (Win- 
chester, Virginia)." Perhaps there is a 
chance of misinterpretation of just what 
goes on around here! One can do some 
things around the apple tree, a few 
things in the apple tree, but many things 

under the apple tree. If you could insert 
the word "surgery" between "doing" 
and "in," I should be very appreciative. 

LESLIE M. BELL '35 [MAY 1958] 

Is There Death Before Life? 

I used to dislike proofreading; however, 
lest the following succeed by eminent 
domain, I hesitate little in pointing to 
page 20 of the spring Bulletin: "Oliver 
Wendell Holmes was born in 1 809"; and 
later in the same paragraph, "Holmes 
died in 1 804"! At first I thought this was 
a classic case of heart success, "where 
the heart beats better and better 'til 
time runs backward." 
DAVID DOVE '42 [SUMMER 1982 | 

The Nature of the Beast 

In the Alumni Notes, it is stated that I 
am President of the Society of Peloric 
Surgeons, and surely this must be a most 
interesting society! My dictionary defines 
"pelor" as a fetal monstrosity with some 
parts abnormally large. Surely this soci- 
ety must have more intriguing meetings 
than my own, which is the Society of 
Pelvic Surgeons! 

The Unkindest Cut 

Of especial interest in "Dr. Guillotine 
and His Non-Invention" was the date of 
the visit to the priest by the executioner 
Sanson — 1973, 200 years after his exe- 
cution of the French king. The author 
should have revealed the secret of 
Sanson's long life before the days of 
low cholesterol and other fad diets. 


Greatly Exaggerated Reports 

Friday morning my wife, Enid, received 
a phone call from my HMS classmate 
Bob Scully. "Enid," he said, "I'm so 
sorry to read of Lew's death in this 

month's Alumni Bulletin." Enid, like Bob, 
is a pathologist and, like all patholo- 
gists, her middle name is equanimity. 
"Well," she answered, "he was breath- 
ing this morning. Frankly, he didn't look 
any different than he did yesterday." 

Scully countered, "I thought there was 
something funny. The note said he was 
survived by his widow, Sylvia." 

"Really," Enid replied. "Maybe there 
are skeletons of which I'm not aware." 

The importance of this was emphasized 
when we got home and found a message 
from a distraught Sydney Gellis '38, my 
hero and mentor of many years. "Enid, I 
just read the terrible news about Lew, and 
incidentally, I think it's in poor taste to leave 
his voice on the answering machine." 

After phoning him and hearing the 
distress in his voice, she said, "I'll let you 
speak to him." I got on the phone and 
told him this was a very long distance 
call and it was very hot here. 

On Tuesday I received a call from the 
Bulletin's editor. She apologized for the 
error and said she was sorry, but did 
not make clear whether she was sorry 
for the notice or that I was alive or both. 
I assured her that my mother's name was 
Mary and my father's name was Joseph 
and that he was a carpenter. Therefore 
she need not worry. (I am still confused 
as to whether the Bulletin's announcement 
of my death was wishful thinking or if the 
school anticipated a large trust.) 

Now the truth is that life and being 
alive are philosophical concepts. When 
Enid related the conversation that had 
alerted her to my untimely demise, I 
immediately went to the EEG lab, where 
squiggles were reported. My pulse ox is 
respectable and my EKG shows electrical 
discharge. Nonetheless, if I am dead — 
legally, that is — -please notify our class 
agent, Chet d'Autrement. 




In past pages of the Harvard Medical Alumni Bulletin, physicians 


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the occasion fleeting; experience 
fallacious, and judgment difficult." 
In his famous aphorism, Hip- 
pocrates offered a humbling per- 
spective on the art of healing. The 
vignettes that follow, culled from 
past issues of the Bulletin, reflect 
this long art, in all its subtleties 
and imperfections, its triumphs 
and limitations. The stories reveal 
the physicianly eye for detail, as 
the authors portray telling clinical 
moments. Although true that, in 
literary matters as in medicine, 
experience can prove fallacious 
and judgment difficult, these read- 
ings, we believe, best capture the 
spirit of the Bulletins long history. 

have reflected on defining moments in their relationships with patients 



between our third and fourth years at HMS. The place: Twill 
ingate, an island off the northeast coast of Newfoundland. Ice- 
bergs shone white in the bay and I was shivering, partly from 
the chill and partly at the prospect of my first home delivery. 
The bag full of sterile goods looked pathetically spare and, as I 
walked up the dusty path leading to the fisherman's cottage, I 
hoped against hope that the baby would get there before I did. 

Minutes later, however, the child was born in an upstairs 
room illuminated by a faltering flashlight. My sense of relief 
was boundless, but short-lived; for when I reached for the pla- 
centa, I was startled to grasp a foot instead. For one anxious 
moment in the dimly lit room, I thought it belonged to the child 
I had just delivered; but a quick check of the infant on the bed 
revealed that all its extremities were intact. "Do I have to go 
through all this again?" wailed Mrs. Pardy, the mother. "Do I 
have to go through all this again?" I echoed. How disgraceful 
now my inattention to details of footling breech deliveries dur- 
ing that third-year lecture on difficult presentations. 

After the second child arrived, I tucked a baby under each 
arm and retreated down narrow stairs to the kitchen where 
appreciative relatives stood waiting. All but the father. He was 
outside operating on a pile of codfish. Elatedly, I called over, 
"You have two!" "These your first?" he asked, barely looking up. 

I learned three things from this experience: (1) a measure of 
self-reliance; (2) that it is possible to get by on less; and (3) that 
the reason for having water boiling during a home delivery is so 
everybody can sit about afterward with a cup of hot tea. 

clement hiebert '51 
[summer 1981] 

Rude awakenings 

The phone rang deep in the night. It was the 
emergency room. A scalp laceration. 

A call to the emergency room is never wel- 
come. It always interrupts something: reading, 
playing catch, eating, watching a favorite tele- 
vision show, even making love. It is always 
imperative. If one tries to put it off, one feels 
guilty and worries about being reported to the 
ER committee. A doctor of introspective bent can 
always examine his motives with interest. One 
influenced by Thomas A. Kempis can make 
spiritual use of such a call. 

I rose from my bed, roused out of a deep 
layer of sleep, and thought something about an 
opportunity to exercise my gift for patience. I 
felt comfortably virtuous as I drove up Sunset 
Avenue to the hospital. I even took the trouble to 
remind myself, with God listening, that it wasn't 
such a great sacrifice. Sure, the patient was 
drunk and would doubtless not pay for having 
his laceration sutured. Yet, how big a deal was 
that, compared, for instance, to the crucifixion? 

I noticed a tall woman smoking just outside 
the door to the ER. She was dressed in a bright 
maroon, very short dress, wore long bangles 
from her ears, seemed hideously overdone 
with makeup, and had her hair swept up in 
an extravagantly bold coif. I think I remember 
something glittering in it. 

My guess was that she was a prostitute. 
Remembering Mary Magdalene, I gave her my 
most compassionate smile, hoping it conveyed 
a gracious lack of prejudice and nonjudgmental 
kindness. There but for the grace of God... 

I nodded. "Good evening," I said. 

Her eyes slowly and insolently swept me 
from head to foot and back again. "Well," she 
said. "You sure took your damn sweet time, 
didn't you?" 

[SPRING 1992] 



Express delivery 


nurse-midwives navigated eastern Kentucky's rough 
terrain on horseback. One day, so the legend goes, a 
young boy inquired of his expectant mother, "Mama, 
where do babies come from?" "Why," she answered, 
"the midwives bring them in their saddlebags." Since 
then, this story has been passed on throughout 
Kentucky's mountain communities. 

Eastern Kentucky is all hills and hollows, and in 
the tiny town of Hyden, nestled at the bottom of one 
of those hollows, it is said that the only way to see 
the sun shine is to lie on your back between 10:00 
a.m. and 4:00 p.m. I first arrived in Hyden in 1973 to 
embark on a two-year stint as the medical director 
of the Frontier Nursing Service, a pioneering pro- 
gram that trains and sends nurse-midwives to the 
homes of expectant mothers. There I found a primi 
rive wooden hospital with a single operating room 
the size of a large closet, complete with a wet mop 
and mousetrap in the corner. 

During those two years, I learned what 75 years oi 
dedication by the nurse-midwives had meant to the 
people of eastern Kentucky. One day, I fielded a call 
over the short wave radio from a nurse -midwife who 
announced, "I'm bringing in a patient with a ruptured 
ectopic pregnane)'!" The nurse soon appeared in her 
Land Rover, her patient attached to an intravenous 

,4 I found a primitive wooden 
hospital with a single operating 
room the size of a large closet, 
complete with a wet mop and 
mousetrap in the corner." 

line and securely bedded on the floor of the vehicle. 
The woman's husband was offering her comfort. My 
interview and exam turned out to be superfluous, 

because the nurse had coolly brought the situation 
under control. When I operated, I evacuated consid- 
erable blood from the patient's abdomen, clamped and 
removed the bleeding fallopian tube, 
closed the abdomen, and reported to 
the husband. He listened politely, but 
directed most of his questions to the 
nurse, as was proper. She was the 
person he knew, and the one who had 
intervened immediately to save his 
wife's life. To him, I was just another 
pair of hands. 

[SPRING 2000] 





soundproof chamber with a heavy door, 
like a bathysphere. Silence at first, then 
the slow crescendo of the tinnitus that 
appears when I am in a quiet place, the 
song of a thousand demented cicadas. 
Behind a panel of dials and switches, I 
can see the face of the audiologist as she 

ents, toward a last minute decision to 
forget physics and attend medical school. 
First year of medical school. Le Nazze 
di Figaro with friends. We have good 
seats, but I have forgotten my hearing 
aid. Mouths are opening and closing on 
the stage. There is a buzzing sound that 
must be connected to the sawing of the 

raises the volume, obviously disap- 
pointed and increasingly concerned. 
Two huge loudspeakers, inches from 
my face, are mute to me. I feel I am sink- 
ing through depths. The audiologist 
turns up the volume further, until I 
hear a faraway pulsing beep. I am found 
to have mild to moderate hearing loss, 
due to otosclerosis. 

After I failed the audiogram and was 
fitted with a hearing aid, my grades 
rapidly rebounded, but my life felt huge- 
ly changed. I dreaded the future. I was 
suddenly and uncomfortably aware of 
my mortality — it seemed that a part of 
my body had prematurely died. My pre- 
vious stance of detached ncrdiness no 
longer seemed an adequate answer to 
life. These feelings nudged me, along 
with the nudging of two physician par 

violins. The flutists are urgently but 
silently fingering their flutes. Louder 
passages are musically clear but word- 
less. I am bored and itch to leave. 

Third year, emergency room rotation. I 
am using my father's ancient stethoscope 
with oversized tubes. I clear an asthmatic 

child for discharge. There are no wheezes. 
The attending physician listens, tells me 
there are still wheezes, and shows me 
where to find them. I listen again, hard, 
but hear nothing. It is clear that I will not 
be an emergency room physician. I am los- 
ing five decibels a year, with no sign of the 
remission usual in otosclerosis, and no 
benefit from stapedectomy. 

Otosclerosis is not supposed to strike 
this hard, or this young. A CT scan 
shows dozens of foci of active disease, 
spicules of out-of-place bone attacking 
middle ears, cochleae, and auditory 
nerves. The disease is hereditary, and 
my father's case is more typical: his mild 
hearing loss was surgically corrected 
and barely affected his career. 

I had enjoyed my psychiatry rotation 
on a consultation service, and had vol 
unteered at a crisis hotline in college 
after the suicide of a friend. Pathology 
and radiology, the only other apparent 
choices, seemed likely to increase social 
isolation. Psychiatry also offered a 
chance to explore the subjective world, 
a nice mirror image to my college inter 
est in deeply understanding the objec 
tive one. I began telling anyone who 
asked, with a confidence born equally 
of ignorance and bravado, that I would 
be a psychiatrist for the deaf. 

sanjay gulati, md 
[winter 1998] 

"I have forgotten my hearing aid. 
Mouths are opening and closing 
on the stage. There is a buzzing 
sound that must be connected 
to the sawing of the violins." 



Perfect pitch 

In a dark corner of a veterans' hospital lies a 
man exiled from this world. He barely moves, 
eats little, does not speak, recognizes no one. 
His face, a stubbly mess, shows neither plea- 
sure nor displeasure — just a constant indiffer- 
ence ever since a stroke devastated him ten 
years ago. An artery in his left brain had 
ruptured, spilling a river of blood in his head, 
drowning out reason and memories, clogging 
his once brilliant mind. His family left him 
long ago. 

Now this man lies on a miserable cot, 
vacant and opaque. He looks a decade older 
than his 67 years. His face is gnarled and 
unshaven, his streaks of white hair are in dis- 
array, his mouth is twisted and drooling. His 
eyes stare at the fluorescent light above, an 
artificial brightness that never varies. 

Face to face with him, I start singing an 
old Anglican hymn, "Come down O love 
divine." His face stirs with recognition, his 
eyes begin searching, his breath quickens, his 
right hand twitches. I sing another verse, and 
another. I now see his face wince, question, 
beg, protest. His breathing has become irreg- 
ular, his face human. His mouth tenses in an 
effort to speak; warm tears soak his eyes. 

Every week I would sing to this man, and 
every week I would witness a remarkable 
awakening. He never spoke, but would join in 
the singing of hymns with his feeble, eggshell 
voice. It was as if after years of hibernation, 
he was starring to thaw, to move, to live 
again. Through this window of music, a ray of 
light seemed to shine from the outside world 
directly onto his soul. 

Throughout history, music has been used to 
invoke God, call armies to war, marry, bury, 
baptize, and express the sublime and the 
beautiful. The Bible describes David's playing 
his harp to ease King Saul's physical and men- 
tal suffering. Today, as we discover its bound- 
less potential, music is used in hospitals 
and clinics to alleviate pain, reduce anxiety, 
reclaim lost memories, enhance learning, and 
restore order, beauty, hope, and meaning in 
patients' lives. I have always believed in the 
tremendous power of music to reach the soul 
and to promote physical and emotional well- 
ness. After leaving medicine to pursue a full- 
time career in orchestra conducting, I return 
sometimes to the corridors of healing, this 
time bearing song. 

[SUMMER 1999] 

Book of the dead 


Egyptian mummy than a real human form. It made all the inci- 
sions and dissections easier — more like digging at an archeo- 
logical site than actually intruding into a human body. My lab 
partners and I gave her a nickname, of course: La Comtesse 
In nominee de LAnatomie. It had class; it smacked of the aris- 
tocracy, fine breeding, noble carriage, and masquerade balls 
with champagne. 

It was a funny thing, the degree of familiarity that my anatomy 
partners and I displayed toward Innominee. We talked to her as 
we worked. She was our first patient in many ways. We thanked 
her for being lean when it came to dissecting out the musculature 
and we cursed her just as readily when her abdominal organs 
were too adherent with cancer to be properly dissected. She 
taught us a lot more than anatomy in her patient, silent way. 

Later in the spring, I was with a young internist who was 
called to pronounce a patient dead on the wards. The patient 
had died of pneumonia. She did not look all that different from 
Innominee, just a little pinker and a little less wrinkled. She 
smelled of the urine that had run all over her bedsheets. She 
was still infectious and dangerous though; Innominee was not. 
No matter how massive the metastases were in Innominee, 
they were all safe to handle, fixed in their malignancy by the 
all- pervasive formalin in the veins. 

Then I did something I never expected to do, nor even 
remember thinking of doing at a conscious level: I reached out 
and touched the body of the recently deceased patient. Behind 
the curtain that hid her from the rest of the world I touched her. 
The skin was so warm it felt as though it could burn. The skin 
was so pliant my fingers sank into it. It was like touching 
human warmth for the first time in my life. A last breath 
trapped in the motionless lungs escaped in an awkward kind of 
weak burp. O my God, I thought, this is it. This is the great 
dividing line; this is the absolute irrevocable step. The doctor 
simply looked at me with a mixture of curiosity and compas- 
sion. As he left the room in front of me, he said over his shoul- 
der, "I always take this sort of thing very seriously." He then 
duly recorded the facts about the end of this life, the examina- 
tion he had performed, and the time — always the time. 




School of Public Health," as she often informed airline reser- 
vation desks. We grew up in rural Haiti, where on a family 
outing we might see a mother of infant twins lying on the 
ground in front of her shack while her babies nursed in 
tandem. My mother would likely stop and encourage her: "let 
maman se pli bon let!" (mother's milk is the best kind!). We 
might hear stories from Dad on why a man had pushed his way 
to the front of the market crowd waiting for immunizations: 
"Doc, you have to let me go first. I need to run home and give 
my pants to my brother so he can put them on and come and 
get his immunizations too." 

We would sing Creole songs by health educators on how to 
make oral rehydration solution from local products. We would 
stop and look at a cooking pot perched on three rocks over a 
charcoal fire on the ground. Besides remarking on the excellent 
protein content of the Haitian 
national dish of sos pwa, red beans 
and rice, Mom would admonish the 
cook to come back for her third 
tetanus immunization, pointing out, 
"If you took away one of the three 
rocks, the cooking pot would fall 
down, right? Well that's what can 
happen to your baby if you don't get 
all of your vaccines!" 

The annual Christmas pageant 
at Hopital Albert Schweitzer in 
Haiti takes place on a tennis court, 
with live donkeys and goats in the 
manger. At age five, I called out 
loudly during the pageant, "Who 
'Hush," I was told, "it was probably 
The next question was logical and 
the obvious one to ask: "Why didn't baby Jesus get tetanus?" 
Why not indeed? It is a miracle that never seems to get dis- 
cussed in church. 

Fast forward 30 years: I am "Dr. Ruth Berggren of UT South- 
western Medical School in Dallas," but my patients know me 
simply as "Doctora Ruth." They are Hispanic women with HIV, 
gay men, and injection drug users coinfected with hepatitis C. 
I try to teach about adherence to complicated regimens. ("You 
know how that stool you are sitting on has three legs? What 
would happen if I cut off one of those legs? You'd have an unsta- 
ble situation there, right? Well, that's what will happen if you 
take only two of your three antiretroviral medications.") Next I 
may counsel a woman with HIV who brings with her a healthy 
child, one who did not become infected with the virus. We will 
remark upon this miracle, and talk about how to keep the child 
healthy. And so it continues. 

[SPRING 2001] 

cut the umbilical cord?" 
Joseph, with a machete 

A royalist pain 

Twenty-five years ago, in the days of the New 
Deal, an orthopedist asked me to see a rich 
private patient who had torticollis. He had been 
unable to find evidence of arthritis or other 
local lesion and was asking me what neurologi- 
cal or psychiatric condition might explain the 
persistent and incapacitating pain in the patient's 
neck. I made a careful neurological examina- 
tion, talked with the patient about an hour in 
all, and left for the day with a rather uninterest- 
ing history and no positive neurological findings 
except spasm of certain neck muscles. 

Not having obtained any lead as to what 
caused the pain, I went in the next day, sat 
down beside the bed, and asked, "Well, who 
is a pain in the neck?" The reply was explo- 
sive — "Roosevelt is a pain in the neck!" Then 
followed an eruption of vituperation against 
Roosevelt and all his ways; he had "ruined" 
my patient's business, "confiscated" his profits, 
impaired his liberty, and changed his way of 
life so that family tensions were rising. It was 
a dramatic and emotional exposition of the 
point of view held at that time by the men 
Roosevelt was calling "Economic Royalists." 
The patient pushed away his hot pack, sat up 
in bed, gesticulated and spoke loudly, drop- 
ping entirely his passive invalid attitude. 

Half an hour later he lay back, surprised 
that he had moved so much without pain. 
Several more interviews convinced both the 
patient and me that he had first experienced 
a common "stiff neck" three weeks earlier 
(source unknown), and that this minor and 
usually temporary ailment had been exagger- 
ated and perpetuated by his emotional ten- 
sions. He returned home ten days later still 
convinced that Roosevelt was symbolically "a 
pain in the neck" but with enough insight to 
keep him from again having those symptoms. 




Whose death is it, anyway? 


for the first time 25 years ago as an 
independent, intelligent, professional 
woman who knew what she wanted 
and was used to getting it. She had her 
end of life decision making written out, 
signed, and even notarized. The first 
thing she said after greeting me was, "I 
want you to be aware of my strong wish 
that, should I ever reach a point in my 
life that I am confined to a nursing 
home, or lose my ability to care for 
myself or interact meaningfully with 
other people, I don't want my life pro- 
longed under any circumstances." I lis- 
tened carefully and told her that I 
understood and, within the limits of the 
law, would do my best to comply with 
her wishes. 

Two months later, during a medical 
procedure to head off a threatened 
stroke, the stroke won, robbing her of 
speech and motor control of her right 
arm and leg. Without today's sophisti- 
cated diagnostic tools, it was impossi- 
ble to predict how much recovery was 
possible, and it was then considered 
legally risky to withhold intravenous 
fluids. She had to be revived enough for 
us to discover how devastated her brain 
had been. Then she was sent to a nurs 
ing home, where her brain recovered 
from the fog of acute injury only for her 
to discover, to her horror, that her worst 
nightmare had come true. 

A month later, on my first visit to the 
nursing home, she was sitting in a 
wheelchair in a large room filled with 
residents and staff. She saw me from a 
distance as I entered the room. 


The scream stopped all noise and 
movement in the room. My eyes sought 

with which she could stab, dismiss, or 
plead, depending on her level of anger. 

I sat in front of her and extended 
my hand, which she took with her left 
and held between us as she pleaded, 
"Noooooo.. .noooooo... noooooo.. .nooooo!" 
She put my hand to her cheek and again 
cried, "Noooooo.. .noooooo.. .noooooo!" 
The nurses told me she had not meaning 
fully spoken until then. I left the nursing 
home sucked dry of all emotion. 

A month later, with fear and trepida- 
tion, I visited again, and the scene was 
repeated. In the ensuing months, the 
staff asked that I call before my visits so 
that they could isolate her from the 
other residents and, I suspect, prepare 
themselves for her outbursts. 

Over the next six years, Mabel took 
antidepressants and still pleaded her 
unmistakable case. She tried starving 
herself, but when she became too weak 
to resist, the staff would feed her. When 
she developed seizures, she tried refusing 
medication, only to bring on even 
stronger seizures, which required hospi 
talization and treatment. She tried, over 
and over, to end her life. And I tried, over 
and over, pushing hard within the limits 
of the law, to let her life end. To no avail. 

"She was sent to a nursing home, 
where her brain recovered from 
the fog of acute injury only for 
her to discover that her worst 
nightmare had come true." 

the source of the scream. 1 recognized 
the twisted face and took the full pierce 
of its meaning in a single second. 

"Noooooo!" Mabel repeated, bending 
forward at the waist and pushing 
vaguely and ineffectually on one wheel 
with her only working hand in an 
attempt to get to me. "Noooooo!" 

Attendants and nurses supported her 
as I approached. She had and would for 
ever have only one word — "Noooooo!" — 

Eventually I had to withdraw as 
Mabel's physician. I couldn't take the gut 
ripping experience of her pleading any 
more, because 1 agreed with her utterly 
and yet was powerless. She lived eight 
more years. And I was left wondering 
what right societies and governments 
have to make demands on people in end- 
of-life situations. 

[WINTER 2000] 




For 75 years, Bulletin advertisers 
have peddled remedies for America's 
woes, from diaper rash to despondency 


& Burr ran the first advertisement in the 
first issue of the Bulletin. Two years before 
the stock market crash of 1929, the ad's headline 
declared, "A Good Year to Own Bonds." 

Since that inaugural issue, the Bulletin has carried 
advertising for everything from doctor's suites on 
Beacon Hill ($125 a month in 1936), to financial advice, to diaper delivery 
services. For the Bulletin's first 50 years, though, pharmaceutical companies 
dominated its advertising space. In 1956, an Editorial Board member pon- 
dered the intersection between medicine and marketing. "The Bulletin is a 



$12,000 liability, and this hurts a New England conscience," Rolf Lium 33 
wrote. 'The natural touch for contributions are the pharmaceutical 
houses — those illustrious dispensers of relaxors, tensors, neutralizers, 
and antagonizers. But they have stockholders to soothe, and there are 
advertising managers who stand guardian over the profits." 

Initially, Editorial Board members had been assigned the task of selling ad 
space, Lium added, but, "After much soul- searching, we decided that only a 
professional advertising man could smash the atomic heart of an advertising 
agent." However they were sold, the Bulletin's vintage pharmaceutical ads 
offer a window onto the anxieties and aspirations of a society preoccupied 
with the pursuit of youth, beauty, sex, happiness — and even health. 


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M MUM £"* CCa'Mi »■•*■■ HOMtWAt 

Warnings about the dangers 
of sun exposure were not as 
prevalent in the 01101-19405, 
when these ads appeared, as 
they are today. But the adver- 
tisement on the left does sug- 
gest that "sunbathing may be 
overdone" — which can turn the 
bathing beauty on the left into 
the baked beauty on the right. 

Take the burn out of 










of Benzedrine lnhalci 

a i[ u common siiijl B 
(ubc tan he earned in pocket or hasdtug i- ■■■ 

II ':linuc.iei itonuun. *i 

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fsuoiu'l; :hc f 4.-. 1 1 

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riuic - peuticj ogiul to or greater dun i£i? trf q> nan-« 1 : 4 
be ^inr»orwCucidtryrtforg(KnK<e>cauB<ui'li-t 






A 1 935 ad for a Benzedrine inhaler claimed that the 
small aluminum tube "can be used inconspicuously at 
any indicated time" to relieve nasal congestion. The truth 
of this claim depends on one's definition of "inconspicu- 
ously," though the dowager on the left does seem to be 
appreciating the product's convenience. Right: In the mid- 
1940s, the same company marketed Benzedrine Sulfate 
therapy for depression, claiming that it could produce 
"an increased self-assurance, optimism, and sense of 
well-being" — qualities that the renewed man in the center 
clearly possesses. The drug was also touted as beneficial 
to menopausal women, especially when administered in 
conjunction with such measures as electroshock therapy. 






In the 1950s, ads for Doriden, 
a sedative, reminded doctors 
that many of their patients — 
including the "harried house- 
wife, corporation executive, 
or salesman" — might face 
insomnia caused by daily work 
pressures. This ad's model 
seems to have awakened both 
well rested and glamorous 
after taking her prescribed 
bedtime dose. 

for daytime sedation . . . 
or a good night's sleep 

convert your 
patients" to 

c I B A 


(Qlutethlmide CJBA) 
AVERAGE DOSAGE: For Daytime Sedation-0 .25 
Sm. t.l.d. (after meals) ; 0.12S Gm. tablets for children 
over 6, elderly patients, and others who require lees 
than 0.2S 6m, 

For Insomnia — O.S Gm. at bedtime. 

SUPPLY: Tablets, 0.125 em., 0.25 Gm. and O.S Gm. 


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"Begone Jinniyeh!" one ad for 
female hormones exclaimed. 
"Gone are the days when 
it was thought necessary to 
consult a witch to cast out 
the female evil spirit — the 
jinniyeh — which possessed 
women during the menopause. 
Now Di-Ovocylin can cast out 
the 'evil spirit' by a series of 
hypodermic injections." 


"-:' ..;. : ffi ■' '. ' 


The word "pablum" has 
acquired a negative connota- 
tion over the years, but in 
the 1 940s, the "palatable 
cereal" was promoted as a 
way to help children grow 
up strong and feisty. On the 
right, 1 950s advertisements 
peddled the liquid vitamin 
Mulcin as "an achievement 
in pharmaceutical elegance," 
for its "unexcelled flavor and 
physical qualities." 




"Well brarcd in limbs, limn, nt'll mired, 
spirited, strong In think und uct, iik the 

rtr n ffrrt nt f rB o\ men pme . . . ." 

r i 11 \ \ ii ii i \ 


M <« j !ii i. ' , i »i i L.M i «j l . l . li l«l «i;nmv.i.'.ii«!Tr 





An ad for a male hormone 
supplement proclaimed that 
it would help men become 
"Well braced in limbs, 
hairy, well voiced, spirited, 
strong to think and act." 





Wartime anxieties took their 
toll, as reflected in this ad's 
warning that "the trauma of 
disturbing psychic influences" 
could result in spastic disorders 
of the gastrointestinal tract. 

because their physician has kept 
her baby well nourished, healthy— and 


free from diaper rash 



Protects against irritation of urine and excrement; 
markedly inhibits ammonia- producing bacteria; 
soothes, lubricates, stimulates healing. 

For samples of Oesltln Ointment, pioni 

812 Branch Avenufe. Providsnee 4. r?.(. 

to 0* 


HB1"' R.V,» Jo„.v„, v 





The bond between mother 
and child was a common 
theme in ads of the 1 950s 
and 1 960s. This charming 
scene of domestic bliss was 
made possible "because their 
physician has kept her baby 
well nourished, healthy — 
and free from diaper rash." 
Desitin, the "pioneer external 
cod liver oil therapy," is still 
selling strong. 






How well do you know 
your HMS lore? 

J. What HMS dean told a graduating class, "Half of 
what we have taught you is wrong. Unfortunately, we 
do not know which half"- 

A. Edward H. Bradford 

B. C. Sidney Burwell 

C. David Linn Edsall 

D. George Packer Berry 

2. HMS students have never received formal instruction 
from which of the following? 

A. Benjamin Spock, author of 
Baby and Child Care 

B. Robin Cook, author of Coma 

C. Fannie Farmer, author of 
The Original Boston Cooking School 
Cook Book, 1896 

P. Robert Coles, author of 
'Children of Crisis 

3. When Charles Eliot (pictured above) became Harvard 
president in 1869, he asked whx HMS only held oral 
examinations. What was the response- 

A. Students must learn to think on their feet. 

B. Oral examinations are more efficient. 

C. We follow the German model of education. 

D. Many of the students can barely write. 

4. Which of the following is not part of the \\ 'arrcn 
Anatomical Museum collection? 

A. Dried skin specimens showing tattoos of 
sailing ships 

B. The connected livers of Chang and Eng, the 
conjoined twins whose national origin gave 
rise to the term "Siamese twins" 

C. A shrunken head prepared by a medical student 

D. A two headed goat 

5. \\ Inch of the following did not claim credit for the 
invention of ether anesthesia? 

A. William T. G. Morton 

B. Charles T. Jackson 

C. Nathan Keep 

D. Horace Wells 




When a prominent physician 
donated his body to Harvard 
Medical School, he became, for 
a time, the literal skeleton in the 
School's closet. Who was the 
generous benefactor? 

A. George Parkman 

B. John Collins Warren 

C. James Jackson 

D. Oliver Wendell Holmes 

Jacob Bigelow, HMS dean from 1820 to 1821, enjoyed 
translating which of the following into Latin and Greek? 

A. Shakespearean sonnets 

B. Short stories by Washington Irving 

C. Mother Goose rhymes 

D. Poems by William Cullen Bryant 

8. What statement did Professor Henry Jacob Bigelow use in 
his argument that the members of the Harvard Corporation 
should not have a hand in reforming education at HMS? 

A. "Reverend Putnam believes that God, not 
medicine, cures disease." 

B. "Mr. Lowell does not attend to the advice of 
his own personal physician." 

C. "Judge Bigelow understands the law only barely, 
and certainly not medicine." 

D. "Mr. Crowninshield carries a horse-chestnut in 
his pocket to keep off rheumatism." 

9. When Clarence John Blake established an aural clinic at the 
Massachusetts Charitable Eye and Ear Infirmary in 1870, he 
had only one piece of equipment, which he used to test hearing 
What was the device? 

A. A dinner bell 

B. A policeman's whistle 

C. A tuning fork 

D. A xylophone 

JO. Thomas Dwight, chair of the HMS anatomy department 
from J883 to 1911, is considered "the father of forensic anthro- 
pology" Research into which subject led him to be an expert 
witness in the important murder trials of his day? 

A. Dactyloscopy, or the art of fingerprint analysis 

B. The trajectory of stab wounds 

C. Methods of determining sex and estimating 
height from bone fragments 

D. Bloodstain analyses at crime scenes 

11. Hazard Medical School's current name came into general 
use only in the 1850s. What was it called before then? 

A. Medical Institution of Harvard University 

B. Boston Medical School 

C. Massachusetts Medical College 

D. All of the above 

12. In 1928, Vanderbilt Hall regulations allowed students to 
entertain womenguests in their rooms from 1:00 to 6:00 p.m. 
On what occasion were visiting hours extended by an hour? 

A. Valentine's Day 

B. Commencement 

C. The Harvard-Yale football game 

D. Mother's Day 

13. When Alice Hamilton became the first woman to join 
the HMS faculty in 1919, she had to agree to forgo what 
symbolic expressions of a faculty rank? 

A. An office in the Quadrangle, a velvet 
Commencement hood, and a portrait 
published in the Aesculapiad 

B. Access to the Harvard Club, participation in 
the Commencement academic procession, and 
tickets to Harvard football games 

C. A gold-headed cane, unlimited library 
privileges, and participation in faculty meetings 

D. Second Year Show tickets, clerical assistance, 
and an insignia-embossed Harvard chair 




What HMS graduate had a dinosaur named after him? 
Which fathered the longest-reigning monarch? And which 
declared that he suffered from Cacoethes scribendi, or the "itch 
to write"? Match the alumni below with their claims to fame. 



1 . What Olympic gold medalist turned down six-figure endorsements and a 
white Cadillac in order to be able to focus on surgical studies at HMS? 

2. What environmentalist is now the honorary president of the Sierra Club? 

3. What philosopher conducted experiments in such phenomena as clairvoyance, 
telepathy, and religiously induced states of consciousness? 

4. What ophthalmological surgeon traded in his scalpel for a conductor's baton? 

5. What biochemist gained international fame for his nature photography? 

6. What Amazon Basin explorer built a geographical institute at Harvard? 

7. What surgical resident and New Yorker author was given the nickname "Egghead" 
while serving as an advisor to Bill Clinton's presidential campaign in 1992? 

8. What award-winning fiction writer helped found a program aimed at fostering 
a love of reading in children? 

9. What cardiac surgeon is now serving in the U.S. Senate? 
10. Who helped author the modern rules of baseball? 

1 1 . Whose famous poem "Old Ironsides," penned when he was a law student, 
helped ensure the preservation of the famous frigate the USS Constitution? 

12. What former football player became an orthopedic surgeon after his team 
won the Super Bowl? 

13. What natural health expert has gained an international following? 

14. What critically acclaimed novelist and short story writer teaches fiction writing 
at the Iowa Writers' Workshop? 

15. What cartoonist-cardiologist sketched clinical scenes during World War II? 

16. What novelist financed his medical education by writing pseudonymous thrillers? 

17. What syndicated columnist won a Pulitzer Prize for distinguished commentary? 
1 8. What psychiatrist is a commentator for National Public Radio's "All Things 


19. Who was known as the father of modern medicine in his native country? 

20. What medical school dean won a National Book Award for his compelling essays? 

21 . What former "ER" producer now serves as executive producer of "Law & Order: 
Special Victims Unit"? 

22. What internist is an award-winning poet with four books of poetry to his credit? 

23. What author, under the pseudonym "Samuel Shem," set the medical 
establishment on its ear when he penned The House of Cod? 

24. What New Yorker served as governor of the Territory of Alaska for 14 years 
and became known as "the father of Alaska statehood"? 

a. Lewis Thomas '37 

b. Ethan Canin '92 

c. William James, 1869 

d. Elissa Ely '88 

e. Stephen Bergman '73 

f. Ernest Gruening '12 

g. Mark Adickes '00 
h. Eliot Porter '29 

i. Michael Crichton '69 

j. Prince Mahidol of Songkla '28 

k. Neal Baer '96 

I. Perri Klass '86 

m. Ernest Craige '43A 

n. Rafael Campo '92 

o. Tenley Albright '61 

p. Atul Gawande '94 

q. Alexander Hamilton Rice, 1904 

r. William Frist '78 

s. Oliver Wendell Holmes, 1 836 

t. Edgar Wayburn '30 

u. Andrew Weil '68 

v. Samuel Wong '88 

w. Daniel Lucius Adams, 1 838 

x. Charles Krauthammer '75 


KEY: l.o2. t 3. c 4. v 5. h 6. q 7. p 8. 19. r 10. w 11. s 12. g 13. u 14. b 15. m 16. i 17.x 18. d 19. j 20. a 21. k 22. n 23. e 24. f 
EXTRA CREDIT: Answers to the initial questions: Michael Crichton '69, in whose honor, as author of Jurassic Park, a newly discovered dinosaur was named 
Bienosaurus crichtoni in 2000; Prince Mahidol of Songkla '28, whose son, King Bhumibol Adulyadej, has sat on Thailand's throne since 1946; and Oliver 
Wendell Holmes, Class of 1836, who also claimed to have "lead poisoning," which afflicts writers when the mind makes contact with printer's type. 

What dean was credited with introducing the micro- 
scope and the stethoscope to the HMS curriculum? 

A. Oliver Wendell Holmes 

B. George Shattuck 

C. Walter Channing 

D. Henry Pickering Bowditch 

15. Which "anatomy" test question stumped and panicked 
a number of HMS students in the 1960s? 

A. Where is the Mandibular Canal? 

B. Where are the Islets of Langerhans? 

C. Where is the Fissure of Rolando? 

D. Where is the Circle of Tugo? 

16. On whom did Benjamin Watcrhouse, a founding faculty 
member of HMS, perform the first smallpox vaccinations in 
the United States? 

A. His private patients 

B. His stable hands 

C. His HMS students 

D. His children and domestic servants 

17. HMS Dean John Collins Warren was instrumental in get 
ting the Anatomical Law passed in 1831. Until then, it had 
been illegal to procure bodies for dissection purposes — aprob 
lem that led to grave robbing. The Anatomical Law enabled 
HMS students to dissect the bodies of which of the following? 

A. Poor immigrants who had died without the 
means for burial fees 

B. Unclaimed corpses 

C. People who had died while patients on the 
wards of Harvard- affiliated hospitals 

D. Executed criminals 


Numbers that reveal the history of Harvard Medical School 

HMS tuition when the Bulletin debuted 
in 1927: $400 

HMS tuition for 2002-2003: $30,500 

Average number of new HMS graduates 
who chose emergency medicine in the 
eight years before "ER" first aired: 2 

Average number of new HMS graduates 
who chose emergency medicine in the 
eight years after "ER" first aired: 6 

Amount of grant money that HMS refused 
in 1 880, so it could continue to deny the 
admission of female applicants: $50,000 

Amount in current dollars: $877,193 

Number of years after HMS was founded 
that it opened its doors to women: 163 

Number of years after HMS first admitted 
women that they outnumbered men in an 
incoming class: 50 

Number of years after HMS accepted women 
that the Bulletin published a secretarial 
recruitment ad that promised to provide 
"unmarried daughters of alumni" with "high 
salaries, attractive fringe benefits, and 
exciting extracurricular activities!": 13 

Number of years after HMS accepted 
women that the Bulletin published a "Notice 
to Alumni Fathers of Sons Who Are Planning 
to Apply to Harvard Medical School": 19 

Number of living HMS graduates: 
approximately 8,700 

Number of HMS graduates awarded the 
Nobel Prize: 14 

Number of HMS graduates awarded an 
Olympic gold medal: 1 


18. The HMS seal, with its image of a rampant lion, draws 
from the family crest ofwhieh early faculty member? 

A. John Warren 

B. Benjamin Waterhouse 

C. Aaron Dexter 
D.James Jackson 

19. In what year did HMS begin requiring an academic 
degree for admission? 

A. 1848 

B. 1881 

C. 1901 

D. 1924 

20. In 1896, Walter Dodd, a pharmacist at Massachusetts 
General Hospital, used a hand cranked Holtzstatic machine 
to power the hospital's first x-rays. For what purpose had the 
device been previously used? 

A. To administer electrical shocks to patients 
with nerve disorders 

B. To spark repressed memories in patients 
with head injuries 

C. To study gastric motor activities under 
normal conditions 

D. To restore normal heart rhythm to patients 
with arrhvthmia 

21. Walter Charming, one of the early deans of HMS, was 
dismissed from Harvard College in 1S07 for participating 
in which of the following? 

A. A cheating scandal involving a Latin exam 

B. A student food rebellion 

C. A drunken brawl following a Harvard-Yale 
rowing competition 

D. A prank that resulted in the accidental 
destruction of a library bust of John Harvard 

22. In 1849, authorities discovered that a local physician, 
George Parkman, had been murdered on HMS premises, in 
the chemistry laboratory of Professor John White Webster. 
Where was Parkmans body found? 

A. The furnace in Webster's laboratory 

B. A large wooden tea chest 

C. A hole beneath Webster's private privy 

D. All of the above 

Answers: 1 B; 2 A; 3 D; 4 B; 5 C; 6 B; 7 C; 8 D; 9 A; 
10 C; 11 D; 12 C; 13 B; 14 A; 15 D; 16 D; 17 B; 18 A; 
19 C; 20 A; 21 B; 22 D 

Special thanks to the incomparable stall of the Department of Rare 
Books and Special Collections at the Countway Library of Medicine 
for providing research on a number of these questions. 

Number of HMS deans who have shared a name with a 1950s crooner: 1 

Number of faculty members when HMS 
was founded in 1782: 3 

Number of HMS faculty members today: 
nearly 8,000 

Number of years it took to build that 
marble marvel, the Taj Mahal: 22 

Number of years it took to build that 
marble marvel, the HMS Quadrangle: 3 

Number of times HMS has been listed as 
the country's top medical school for research 
in the 13 years U.S. News & World Report 
has been publishing the listings: 13 

Number of pages the Bulletin has published 
in the past 75 years: 16,342 

Number of Bulletin pages on which Buffy 
the Vampire Slayer has appeared: 1 

Number of Bulletin issues from the 1930s 
that advertised Chesterfield cigarettes: 20 

Number of ads for musical cigarette boxes 
that play "Fair Harvard" when opened: 1 

*With permission from — and apologies to — 
Harper's Magazine, which has been publishing 
"Harper's Index" continuously since 1984. 





Joseph H. Pratt 

1 937 "My wife, Hazel, died on April 
5, 2001. 1 still live at home in 
Rochester, Minnesota. I have 
been on two cruises this year 
and they were fun." 

Frederick C. Robbins 

I 940 has been honored with the 

establishment of the Frederick 
C. Robbins, MD, Professorship 
in Child and Adolescent 
Health at Case Western 
Reserve University. Robbins 
joined the faculty at what is 
now known as the Case West- 
ern Reserve University School 
of Medicine in 1952 as a pro- 
fessor of pediatrics, served as 
dean from 1966 to 1980, and 
was named university profes- 
sor emeritus in 1987. He 
shared the 1954 Nobel Prize 
in Physiology or Medicine for 
his role in research on the 
polio virus. 

John E. Ste wa rt 

1 94 1 "I am fortunate to be living in 
a retirement community, after 
having been hit by a viral 
meningitis last year. I have 
recovered enough to walk 
with crutches, thankfully" 

Walter Pick 

patients who are establishing 
the Hermes Grillo Professor- 
ship of Thoracic Surgery at 
HMS and Massachusetts Gen- 
eral Hospital." 

David Chamovitz 

1 942 "With my wife of 59 years, I 
have been fortunate to have 
traveled widely and seen a 
good part of the world. In 
recent years we have enjoyed 
enrichment classes in senior 
education programs. I am 
happy in my memories of 
when medicine was truly 
a profession." 

Hermes C. Grillo 

1 947 "I received the Carl Bakken 
Award for Scientific Achieve- 
ment from the Society of Tho- 
racic Surgeons. I am thankful 
to friends, colleagues, and 


1 948 "My memoir, By All Means, 

Resuscitate, has just been pub- 
lished. The curious among 
you can visit 
bookstore. If you aren't one 
of my many roommates or 
esteemed teachers, don't look 
for your name. As Adam said 
to Eve, These are difficult 
times we are living in.' Such is 
the case with Marcia and me 
in Israel. We work for peace 
while watching our backs." 

Taufick E. Rendeck 

1 949 "I am enjoying retirement. My 
wife, Phyllis, and I spend half 
our time in Florida and the 
other half on our beachfront 
property on Trujillo Bay in 
Honduras. All six of our kids 
are married and working suc- 
cessfully — financially better 
off than I was at their age. 
Thank God!" 

John F. Morrissey 

"I am sorry to report that my 
wife, Ruth, died of recurrent 
lung cancer in December, just 
short of our 52nd anniversary. 

I continue to enjoy living in 
the high desert of central 
Oregon — golf in summer, 
skiing in winter." 

Hart Achenhach 

1950 "I spend a fair amount of time 
as a docent at the Peabody/ 
Essex Museum in Salem, 
Massachusetts. I learn a lot and 
meet interesting people. I also 
volunteer at the Board of Reg- 
istration in Medicine doing 
patient care assessment." 

James B. Field 

1951 "I was selected as Volunteer 
of the Year by the Massachu 
setts Medical Society for the 
program that I initiated for 
retired physicians to volun- 
teer to provide health care for 
uninsured and underinsured 
people in Massachusetts." 

George Risen man 

1953 "I'm still enjoying skiing and 
golf despite an osteoarthritic 
back, spinal stenosis, and a 
39-year-old knee dislocation. 
I don't enjoy walking anymore, 
but Nancy continues to be the 
'Iron Man' in this family!" 

Daniel Federman 

has received the Abraham 
Flexner Award for Distin- 
guished Service to Medical 
Education, the highest honor 
bestowed by the Association 
of American Medical Col- 
leges. The award recognizes 
extraordinary contributions 
to medical schools and to 
the medical education com- 
munity. Federman has been 
involved in shaping educa- 
tion at HMS for more than 
20 years. During his tenure 
as dean for medical educa- 
tion, he was instrumental 
in implementing the New 
Pathway curriculum. He is 
































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